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RR395 - Ten year follow-up study of MR imaging of the lumbar spine

This research study was conducted to establish whether a relationship existed between occupational, lifestyle factors, MRI-diagnosed pathology and low back pain (LBP) over a 10 year period. Epidemiological risk factors for the presence, onset and worsening of LBP over the follow-up period and risk factors for the onset of pathology in the spine were also investigated.

104 subjects were followed up from an original study into the role of MR imaging in the evaluation of LBP. LBP history, occupational and lifestyle characteristics were obtained by questionnaire and 70 subjects underwent successful MRI scans of the lumbar spine. At follow-up, nearly half of all subjects reported having LBP on a monthly basis and MRI-diagnosed pathological features were extensive across the spine particularly at the lower lumbar spinal levels. 19% of subjects developed new-onset pain from none previously, whilst a quarter of subjects’ pain worsened over the study period. 22% of subjects developed onset of pathology in the spine from none previously.

Few factors emerged from multiple logistic regression analysis as being significant independent predictors of frequent, onset and worsening LBP. No risk factors could be established for the onset of disc degeneration or herniation in the spine. Although subjects experienced an increase in pathological features with increasing LBP occurrence, no link could be established to suggest causal factors to the development of new pain or pathology. This supports the idea that pathological change and nonspecific LBP experience in workers is likely to be co-incidental.

This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the author alone and do not necessarily reflect HSE policy.

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Updated 2010-03-19