Relationship between low back pain, disability, MR imaging findings and health care provider.
OBJECTIVE
To determine the association between the self-report of pain and disability and findings on lumbar MR images, and to compare two different health care providers in Spanish patients with low back pain (LBP).


METHODS
Cross-sectional


METHODS
A total of 278 patients, 137 men and 141 women aged 44+/-14 years submitted with low back pain (LBP) were studied. One hundred and nine patients were from the National Health System (NHS) and 169 from private practice. Patients with previous discitis, surgery, neoplasm or traumatic episodes were excluded. Every patient completed a disability questionnaire with six core items, providing a score of disability from 2 to 28. All patients had sagittal spin-echo T1 and turbo spin-echo T2, axial proton-density and MR myelography weighted images. MR images of the two most affected disc levels were read, offering an MR imaging score from 0 to 30.


RESULTS
Patients with a combination of LBP and sciatica showed the highest levels of disability (p=0.002). MR imaging scores only correlated with pain interference with normal work (p=0.04), but not with other disability questions. Patients from the NHS showed greater disability scores than private ones (p=0.001) and higher MR imaging scores (p=0.01).


CONCLUSIONS
In patients with LBP, MR imaging only correlates with pain interference with work but not with other disability questions. Differences are found between private and NHS patients, the latter being more physically affected.
Arana
Estanislao
E
Department of Radiology, Clínica Quirón, Av. Blasco Ibañez, 14, 46010 Valencia, Spain. rmquironv.val@quiron.es
Martí-Bonmatí
Luis
L
Vega
María
M
Bautista
Daniel
D
Mollá
Enrique
E
Costa
Salvador
S
Montijano
Rubén
R
D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D017116:Low Back Pain / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data; D010147:Pain Measurement; D013030:Spain; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires