title: Bone Marrow Edema and Low Back Pain in Elderly Degenerative Lumbar Scoliosis: A Cross-Sectional Study.
abstract: METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  To examine whether bone marrow edema is associated with low back pain in elderly patients with degenerative lumbar scoliosis.
  
  
  BACKGROUND
  The cause of low back pain in degenerative lumbar scoliosis is unclear.
  
  
  METHODS
  A total of 120 degenerative lumbar scoliosis patients 65 years of age or older were evaluated. Radiography, computed tomography (CT), magnetic resonance imaging (MRI), and tender point examination in the lumbar spine were performed. On MRI, coronal gadolinium-contrasted T1- or T2-weighed fat-saturated images were used to score the size of bone marrow edema. The prevalence of bone marrow edema in patients with and without low back pain was compared; in patients with low back pain, we tested whether the locations of lumbar tender point were consistent with that of bone marrow edema.
  
  
  RESULTS
  Bone marrow edema was found in 62 of 64 (96.9%) patients with low back pain compared with 21 of 56 (37.5%) patients without it (P < 0.001). Bone marrow edema located more frequently on the concave side than on the convex side of scoliosis (P < 0.001). Among patients with low back pain, bone marrow edema score was associated with low back pain severity (r = 0.724; P < 0.001), and the location of lumbar tender point were consistent with that of bone marrow edema (κ value = 0.745; P < 0.001).
  
  
  CONCLUSIONS
  Bone marrow edema on MRI was closely associated with the presence of low back pain in elderly degenerative lumbar scoliosis.
  
  
  METHODS
  4.
authors.affiliation: *Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan †Ohta Nishinouchi Hospital, Fukushima, Japan ‡Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan §Muskuloskeletal Research, Department of Medical Chemistry and Cellbiology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamae
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yamada
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Teruaki
authors.initials: T
authors.lastname: Okuda
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Takata
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hiramatsu
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
authors.forename: Kjell
authors.initials: K
authors.lastname: Olmarker
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D004487:Edema / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D010147:Pain Measurement / Q000379:methods; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000453:epidemiology