Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation.

TLDR

We performed MRI on 67 asymptomatic adults and had three blinded neuro‑radiologists independently interpret the scans. Approximately one‑third of the scans revealed significant abnormalities, with prevalence rising sharply with age—20 % of those under 60 had herniated discs (and one case of stenosis) versus 57 % of those 60 and older (36 % herniated discs, 21 % stenosis)—and the authors concluded that MRI findings must be correlated with age and clinical symptoms before considering surgery.

Abstract

We performed magnetic resonance imaging on sixty-seven individuals who had never had low-back pain, sciatica, or neurogenic claudication. The scans were interpreted independently by three neuro-radiologists who had no knowledge about the presence or absence of clinical symptoms in the subjects. About one-third of the subjects were found to have a substantial abnormality. Of those who were less than sixty years old, 20 per cent had a herniated nucleus pulposus and one had spinal stenosis. In the group that was sixty years old or older, the findings were abnormal on about 57 per cent of the scans: 36 per cent of the subjects had a herniated nucleus pulposus and 21 per cent had spinal stenosis. There was degeneration or bulging of a disc at at least one lumbar level in 35 per cent of the subjects between twenty and thirty-nine years old and in all but one of the sixty to eighty-year-old subjects. In view of these findings in asymptomatic subjects, we concluded that abnormalities on magnetic resonance images must be strictly correlated with age and any clinical signs and symptoms before operative treatment is contemplated.