Evidence map›Paper›PMID 40679482›Full record

SynthesisEuropean journal of pain (London, England)2025

Associations Between Sum Scores or Combinations of MRI Findings in the Lumbar Spine and Low Back Pain-Related Outcomes: A Systematic Review.

Line Dragsbæk, Tue Secher Jensen, Per Kjær, Mark Hancock, Stine Clausen, Rikke Krüger Jensen

Abstract readSystematic Review
In one paragraph

Synthesis in European journal of pain (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Age-referenced modeling of lumbar disc degeneration and its association with chronic low back pain: an MRI-based cross-sectional study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  3. Two trajectories of lumbar disc degeneration from adolescence to adulthood: a 23-year longitudinal MRI study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Line DragsbækCenter for Muscle and Joint Health. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.ORCID https://orcid.org/0000-0002-9155-947X
Tue Secher JensenCenter for Muscle and Joint Health. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Per KjærCenter for Muscle and Joint Health. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Mark HancockDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
Stine ClausenCenter for Muscle and Joint Health. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Rikke Krüger JensenCenter for Muscle and Joint Health. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveResearch on lumbar MRI findings has mainly focused on single MRI findings and their association with low back pain (LBP). Some studies suggest that summing or combining MRI findings may show stronger associations with LBP than single findings. This systematic review investigates how sum scores and combinations of lumbar MRI findings are associated with LBP-related outcomes.

methodsWe searched Embase, PubMed, CINAHL, Scopus and SPORTDiscus for studies reporting cross-sectional associations between sum scores/combinations of MRI findings and LBP. Two reviewers independently performed screening, data extraction and risk-of-bias (RoB) assessment. Study characteristics, definitions of sum scores/combinations of MRI findings and associations between sum scores of MRI findings and LBP outcomes were extracted and synthesised.

resultsWe identified 11,537 studies and included 49 with 37 different study populations. Twelve studies had low RoB. Thirty-one studies investigated sum scores of one specific MRI finding. Ten out of 16 studies investigating disc degeneration, two out of three investigating herniation and seven out of 10 investigating endplate-related changes reported stronger associations between increasing sum scores and LBP. Additionally, seven of nine studies reported the same for disc degeneration and LBP-related disability. Sixteen studies investigated a sum score of different MRI findings. Eight of 11 studies reported stronger associations between increasing findings and LBP, and five of eight found the same for LBP-related disability.

conclusionMost studies reported stronger associations between increasing sum scores of MRI findings and LBP. We recommend focusing on cumulative MRI findings when investigating the relationship with LBP outcomes. SIGNIFICANCE STATEMENT: This review emphasises the relevance of assessing MRI findings as a sum rather than as individual findings in understanding the mechanisms of low back pain. The findings offer a foundation for future research, promoting a more standardised approach to the assessment of MRI findings and their clinical relevance.

Indexed as

Intervertebral Disc DegenerationLow Back PainLumbar VertebraeMagnetic Resonance ImagingHumansIntervertebral Disc Displacement

Identifiers

PMID40679482
PMCPMC12273765

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.