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MRI of the Lumbar Spine in People without Back Pain

Bulges or protrusions on MRI in people with low back pain may be coincidental. MRI scans were read independently by two neuroradiologists, with scans of people with and without back pain randomly mixed. The radiologists did not know the clinical status of the people. Of 98 asymptomatic subjects, 36% had normal disks at all levels, 52% had a bulge of at least one level, 27% had a protrusion, and 1% had an extrusion, with 38% having an abnormality of more than one intervertebral disc. The prevalence of bulges increased with age. Of nonintervertebral disc abnormalities, the most common were Schmorl's nodes (herniation of the disc into the vertebral-body endplate) in 19% annular defects (desruption of the outer fibrous ring of the disk) in 14% and facet arthropathy (degenerative disease of the osterior articular processes of the vertebrae) in 8%.

New England Journal of Medicine 1994: 331(2): 69-73