Low Back Pain, and Diagnostic findings in 40 year olds

Low Back Pain, and Diagnostic findings in 40 year olds

Low Back Pain, and Diagnostic findings in 40 year olds

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Every day,  I have consultation with patients that have had lumbar MRI’s,  but with mild complaints. Some primary care physicians  use CT scans to identify causes of low back pain. Fortunately,  while there are some findings on the studies,  it is rare to find a truly emergent finding.  Also,  it was rare to find a truly “normal MRI” as most of my patients are in their 40’s and 50’s.   As a Physician,  we often wonder what are the true rates of lumbar MRI findings for the average middle age population.

We are fortunate that there was a study performed investigating that specific concept.

In the May 2005 Edition of Spine,  Per Kjaer published an article titled “Magnetic Resonance Imaging and Low Back Pain in Adults: A Diagnostic Imaging Study of 40 year old Men and Women”

It was a fascinating population study located in Funen County,  Denmark.    Every ninth person who was born in Denmark between 5/27/1959 and 5/26/1960 who also resided in Funen county was contacted by mail.  In other words,  40 year olds at the time of the study.

Anyone with severe disability,  magnetic implants,  claustrophobia,  or inability to communicate in Danish were excluded.  625 subjects were contacted by mail.  413  (66%) agreed to participate in the study.  Each participant filled out a questionaire.   Each participant was also given a lumbar MRI ( .2 T magnet).  The questionaires were tabulated,  and the MRI’s interpreted by a defined group of radiologists.  Interobserver reliability parameters demonstrated a greater than 98% agreement by the reading radiologists.

The questionaire reflected a 69% incident of back pain in the prior year for all participants.   Disk related findings such as herniations,  bulges, disk narrowing,  etc was found between 25% to 74% of the finding per participant.

There was a weak association between hypointense disc signal,  reduced disk height and Modic type changes.

To me,  the take home message from this study are the following:

Low Back pain is a common experience for 40 year olds.

Disk abnormalities at age 40 is very common.

MRI’s are not very specific,  in terms of determining the cause of low back pain.

I did not need  a scientific study to confirm what I already knew as a practicing spine specialist.  But I am glad the science confirmed my conventional thoughts about the topic.

 

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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