STIR sequence for depiction of degenerative changes in posterior stabilizing elements in patients with lower back pain.
OBJECTIVE
The aims of this study were to investigate whether degenerative posterior paraspinal changes are a cause of lower back pain and to determine the age- and sex-related distribution of these changes on MR images acquired with a STIR sequence.


METHODS
The lumbar MRI findings of 372 patients (141 men, 231 women; mean age, 51.2 years) with nonradicular lower back pain and of 249 healthy persons acting as controls (126 men, 123 women; mean age, 49.3 years) were analyzed. The sagittal STIR sequence was used for all MRI examinations. Presence of interspinous ligament edema, facet joint effusion, neocysts, paraspinal muscle edema, subcutaneous edema, disk herniation, and disk degeneration was evaluated, and the incidence of each finding was determined. All findings were grouped according to age and sex. Chi-square, Fisher's exact, and independent-samples Student's t tests and Spearman's rank correlation analysis were used for statistical analysis.


RESULTS
The incidences of facet joint effusion, interspinous ligament edema, neocyst formation, and paraspinal muscle edema were found to be statistically significantly higher in patients with lower back pain than in controls. The incidences of intervertebral disk degeneration, disk herniation, and subcutaneous edema in persons with and those without lower back pain were similar. Intervertebral disk degeneration, disk herniation, subcutaneous edema, and muscle edema were found to increase with age in both persons with and those without symptoms.


CONCLUSIONS
Degenerative changes in the posterior paraspinal structures were found in a higher percentage of subjects with lower back pain than in controls. Use of a STIR sequence with homogeneous fat suppression facilitates visualization of these changes.
Lakadamyali
Hatice
H
Department of Radiology, Baskent University, Alanya Research Center, Antalya, Turkey.
Tarhan
Nefise Cagla
NC
Ergun
Tarkan
T
Cakir
Banu
B
Agildere
Ahmet Muhtesem
AM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology; D008022:Ligaments / Q000473:pathology; D017116:Low Back Pain / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D012447:Sacrum / Q000473:pathology; D012737:Sex Factors; D018709:Statistics, Nonparametric