Analysis of the iconographic factors related to the low back pain in the patients with lumbar spinal stenosis

English Keywords:Low back pain  Lumbar ｓｐｉｎａｌ　ｓtenosis  Modic changeｓ  HIZ  Segmental instability

English Abstract:

  【Abstract】 Objective：To explore the relationship between the low back pain and imaging findings（segmental instability，high-intensity zone（HIZ）and Modic change）in lumbar spinal stenosis patients.Methods：Retrospective iconographic analysis of 246 patients with lumbar spinal stenosis between January 2007 and January 2010 in our hospital．According to the imaging characristics and the patient symptoms，the data about the images were analyzed and attemtped to find the relationship between the imaging changes（segmental instability，HIZ，Modic changes）and low back pain.Results:The mean age was 59.8 years（range=35-86）.There were 170 patients with low back pain and 76 patients without pain.The incidence of low back pain was 69.1%，and the mean VAS score for back pain was 5.67（range=3.5-9.0）.There were 80 patients with HIZ in which 66 patients had low back pain.The positive rate was 82.5%，χ2=9.96，P<0.01，OR=2.81，95% CI：1.48－5.34.There were 64 patients with Modic changes in which 56 patients had low back pain.The positive rate was 87.5%，χ2=13.71，P<0.01，OR=4.18，95% CI：1.96－8.90.There were 7 patients with Modic changes I stage in which 6 patients had low back pain.The positive rate was 85.7%.There were 44 patients with Modic changes Ⅱ stage in which 40 patients had low back pain.The positive rate was 90.9%.There were 13 patients with Modic changes Ⅲ stage in which 10 patients had low back pain.The positive rate was 76.9%.There were 88 patients with segmental instability in which 74 patients had low back pain.The positive rate was 84.1%,χ2=14.41，P<0.01,OR=3.41,95% CI：1.81~6.43. The correlation between the imaging changes(HIZ, Modic changes,segmental instability)and low back pain was statistical significant（P＜0.05）.Conclusions：Segmental instability，HIZ　ａｎｄ　Modic changes were risk factors resulting in low back pain for lumbar spinal stenosis patients.