title: Is There an Association Between Pain and Magnetic Resonance Imaging Parameters in Patients With Lumbar Spinal Stenosis?
abstract: METHODS
  A prospective multicenter cohort study.
  
  
  OBJECTIVE
  The aim of this study was to identify an association between pain and magnetic resonance imaging (MRI) parameters in patients with lumbar spinal stenosis (LSS).
  
  
  BACKGROUND
  At present, the relationship between abnormal MRI findings and pain in patients with LSS is still unclear.
  
  
  METHODS
  First, we conducted a systematic literature search. We identified relationships of relevant MRI parameters and pain in patients with LSS. Second, we addressed the study question with a thorough descriptive and graphical analysis to establish a relationship between MRI parameters and pain using data of the LSS outcome study (LSOS).
  
  
  RESULTS
  In the systematic review including four papers about the associations between radiological findings in the MRI and pain, the authors of two articles reported no association and two of them did. Of the latters, only one study found a moderate correlation between leg pain measured by Visual Analog Scale (VAS) and the degree of stenosis assessed by spine surgeons. In the data of the LSOS study, we could not identify a relevant association between any of the MRI parameters and buttock, leg, and back pain, quantified by the Spinal Stenosis Measure (SSM) and the Numeric Rating Scale (NRS). Even by restricting the analysis to the level of the lumbar spine with the most prominent radiological "stenosis," no relevant association could be shown.
  
  
  CONCLUSIONS
  Despite a thorough analysis of the data, we were not able to prove any correlation between radiological findings (MRI) and the severity of pain. There is a need for innovative "methods/techniques" to learn more about the causal relationship between radiological findings and the patients' pain-related complaints.
  
  
  METHODS
  2.
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, Department of Internal Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Jakob M
authors.initials: JM
authors.lastname: Burgstaller
authors.affiliation: Department of Computer Science, ETH Zurich, Zurich, Switzerland.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Schüffler
authors.affiliation: Department of Computer Science, ETH Zurich, Zurich, Switzerland.
authors.forename: Joachim M
authors.initials: JM
authors.lastname: Buhmann
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Gustav
authors.initials: G
authors.lastname: Andreisek
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Winklhofer
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.|Department of Radiology, Regional Hospital, Lugano, Switzerland.
authors.forename: Filippo
authors.initials: F
authors.lastname: Del Grande
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, Department of Internal Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Michèle
authors.initials: M
authors.lastname: Mattle
authors.affiliation: Department of Physical Medicine and Rheumatology, Balgrist University Hospital, Zürich, Switzerland.
authors.forename: Florian
authors.initials: F
authors.lastname: Brunner
authors.affiliation: Institute of Neurosurgery, Kantonsspital Winterthur, Winterthur, Switzerland.
authors.forename: Georgios
authors.initials: G
authors.lastname: Karakoumis
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, Department of Internal Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Johann
authors.initials: J
authors.lastname: Steurer
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, Department of Internal Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Held
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000379:methods; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000150:complications* / Q000601:surgery*