Do positive MRI findings in the lumbar spine predict future care-seeking for low back pain in young teenagers?

Background: In MRI studies lumbar disk degeneration and endplate changes have been found in children and adolescents. Such MRI findings appear to be more strongly associated with LBP than in adults. However, this knowledge is mainly based on cross-sectional studies from which no inferences regarded causality can be drawn. The purpose of this presentation is to show how certain MRI findings at the age of 13 indicate seeking care for LBP at the age of 16.

Methods: In a population based longitudinal cohort study two investigations were carried out at a three-year interval (at age 13 and 16). Individuals were sampled to be representative of Danish schoolchildren. Data about seeking care for LBP and lumbar spine MRI were collected independently of each other. The outcome was seeking care for LBP at the age of 16. The potential predictors were positive MRI findings at the age of 13 (disk signal intensity, nucleus form, annular tears, high intensity zones, bulging, herniation, nerve root compression, endplate changes, Modic changes, and spondylolisthesis). Associations were sought through logistic regression at each lumbar level for boys and girls separately. Statistically significant results were presented as odds ratios with 95% confidence intervals.