RESUMEN
BACKGROUND: Neck pain and headache are highly prevalent conditions and leading causes of disability worldwide. Although MRI is widely used in the management of these conditions, there is uncertainty about the clinical significance of cervical MRI findings in patients with neck pain or headache. Therefore, this study aims to investigate the association between cervical degenerative MRI findings and self-reported neck pain, neck disability, and headache. METHODS: This study was a secondary analysis of a cohort of patients with low back pain aged 18-40 years recruited from a non-surgical outpatient spine clinic. The cervical MRI and outcome measures used in this analysis were collected at a four-year follow-up (2014-2017). Self-reported outcome measures included neck pain intensity, neck disability as measured by the Neck Disability Index, and headache as measured by a single NDI item. Cervical MRI findings included disc degeneration, disc contour changes, and vertebral endplate signal changes (VESC). Multivariable logistic regression analyses, adjusted for age and sex, were used to analyse the associations between MRI findings and neck pain, neck disability, and headache. RESULTS: A total of 600 participants who underwent MRI and completed the relevant questionnaires at follow-up were included. The median age was 37 years (interquartile range 31-41) and 325 (54%) were female. Of the included participants, 181 (31%) had moderate or severe neck pain, 274 (59%) had moderate or severe neck disability, 193 (42%) reported headaches, and 211 (35%) had one or more cervical degenerative MRI findings. Cervical disc degeneration and disc contour changes were positively associated with moderate or severe neck pain with odds ratio 1.6 (95% CI 1.1-2.4) and 1.6 (1.1-2.3), respectively. VESC was associated with moderate or severe neck disability with odds ratio 3.3 (1.3-8.4). No statistically significant associations were found between the MRI findings assessed and headache. CONCLUSIONS: In this cross-sectional exploratory study, we found that cervical disc degeneration and disc contour changes were associated with neck pain, and VESC was associated with neck disability. None of the MRI findings were associated with headache. The results suggest that cervical degenerative changes may contribute to the aetiology of neck symptoms, but the associations are modest and cannot guide clinical decisions.
Asunto(s)
Degeneración del Disco Intervertebral , Humanos , Femenino , Adulto , Masculino , Degeneración del Disco Intervertebral/diagnóstico por imagen , Dolor de Cuello/diagnóstico por imagen , Autoinforme , Estudios Transversales , Imagen por Resonancia Magnética , Cefalea/diagnóstico por imagenRESUMEN
BACKGROUND: The Lumbar sagittal parameters might be related to modic changes (MCs). However, studies on this topic have rarely been reported. The aim of this study was to identify the relationships between the lumbar sagittal parameters and the development of MCs. METHODS: The lumbar sagittal parameters of 321 patients with chronic low back pain from May 2016 to August 2018 were measured on X-ray by using Surgimap surgical planning software. Univariable analyses were used to test the potential variables of interest. Logistic regression models were then performed for the significant parameters to identify the independent factors associated with the development of MCs. RESULTS: More patients in the MCs group were older with more number of female than in the disc degeneration group (p < 0.05). In the univariate analysis, significant differences were detected for the parameters of lumbar lordosis, sacral slope, intervertebral height index, endplate concave angle, and intervertebral angle only at the L5/S1 level between the two groups. The results of logistic regression analysis showed that a smaller intervertebral height index was positively associated with the development of MCs at the level of L3/4 (p < 0.05). However, the positive role of gender was only for MCs at the L5/S1 level (p < 0.05). CONCLUSIONS: The results of this study revealed that there were negative relationships between the lumbar sagittal parameters and MCs. Furthermore, being female and having a narrow intervertebral space were the independent risk factors for the development of MCs at the corresponding lumbar levels. Interestingly, body mass index might be not associated with MCs for the Chinese population.