Do findings identified on magnetic resonance imaging predict future neck pain? a systematic review

Publication date: Available online 2 February 2018
Source:The Spine Journal
Author(s): Laura Hill, David Aboud, James Elliott, John Magnussen, Michele Sterling, Daniel Steffens, Mark Hancock
Background ContextMagnetic resonance imaging (MRI) has the potential to identify pathology contributing to neck pain. However, the importance of findings on MRI remains unclear.PurposeTo investigate whether findings on cervical spine MRI predict future neck pain.Study DesignSystematic review.Patient SamplePeople with or without neck pain.Outcome measuresClinically important neck pain outcomes such as pain and disability. Methods: The review protocol was registered on PROSPERO [CRD42016049228]. MEDLINE, CINAHL and EMBASE databases were searched. Included were prospective cohort studies investigating the association between baseline MRI findings and clinical outcome. Cohorts with serious underlying diseases as the cause of their neck pain were excluded. Associations between MRI findings and neck pain outcomes were extracted from the included studies.ResultsA total of twelve studies met all inclusion criteria. Eight studies presented data on participants with current neck pain, two studies included a mixed sample, two studies included a sample of participants with no current neck pain. Due to the heterogeneity between the studies in terms of MRI findings, populations and clinical outcomes investigated, it was not possible to pool the results. No consistent associations between MRI findings and future outcomes were identified. Single studies of populations with neck pain reported significant associations for neck muscle fatty infiltrate (risk ratio (RR) 21.00, 95% CI 2.97 to 148.31) with persistent neck disability; disc protrusion (mean difference (MD) ranged from -1.83 to -2.88 on 10- point pain scale) and disc degeneration (RR: 0.59; 95% CI: 0.36 to 0.98) with neck pain. In a population without pain, the development of foraminal stenosis over a 10 year period was associated with development of neck pain (RR: 2.99; 95% CI: 1.23 to 7.23).ConclusionsThe limited number, heterogeneity and small sample size of the included studies, do not permit definitive conclusions on the association between MRI findings of the cervical spine with future neck pain.



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