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Semin Musculoskelet Radiol 2022; 26(04): 424-438
DOI: 10.1055/s-0042-1748912
Review Article

Degenerative Lumbar Spine Disease: Imaging and Biomechanics

Maxime Lacroix
1   Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
2   Department of Radiology, Hôpital Européen Georges-Pompidou, Université de Paris, Paris, France
,
Christelle Nguyen
3   Department of Physical and Rehabilitation Medicine, Hôpital Cochin, Université de Paris, Paris, France
,
Robert Burns
1   Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
,
Amandine Laporte
1   Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
,
François Rannou
3   Department of Physical and Rehabilitation Medicine, Hôpital Cochin, Université de Paris, Paris, France
,
Antoine Feydy
1   Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
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Abstract

Chronic low back pain (CLBP) is one of the most common diagnoses encountered when considering years lived with disability. The degenerative changes of the lumbar spine include a wide spectrum of morphological modifications visible on imaging, some of them often asymptomatic or not consistent with symptoms. Phenotyping by considering both clinical and imaging biomarkers can improve the management of CLBP. Depending on the clinical presentation, imaging helps determine the most likely anatomical nociceptive source, thereby enhancing the therapeutic approach by targeting a specific lesion. Three pathologic conditions with an approach based on our experience can be described: (1) pure painful syndromes related to single nociceptive sources (e.g., disk pain, active disk pain, and facet joint osteoarthritis pain), (2) multifactorial painful syndromes, representing a combination of several nociceptive sources (such as lumbar spinal stenosis pain, foraminal stenosis pain, and instability pain), and (3) nonspecific CLBP, often explained by postural (muscular) syndromes.

Keywords

spine - diagnostic Imaging - magnetic resonance imaging - pain - low back pain


Publication History

Article published online:
14 September 2022

© 2022. Thieme. All rights reserved.

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