Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

Background

There is uncertainty regarding the clinical significance of findings on MRI in patients with whiplash associated disorder (WAD) or nonspecific neck pain (NSNP).

Purpose

To compare the presence of cervical spine MRI findings in people with WAD or NSNP with pain‐free controls.

Study Type

Systematic review and meta‐analysis.

Population

Adults with WAD (n = 994), NSNP (n = 715), or pain‐free controls (n = 2323).

Field Strength

0.5T, 1.5T, and 3.0T.

Assessment

Medline, EMBASE, CINAHL, Web of Science, SCOPUS, and Cochrane CENTRAL databases were searched. Two independent reviewers identified studies for inclusion and extracted data. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Overall quality of the evidence from meta‐analysis was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach.

Statistical Tests

Meta‐analysis was performed using a random‐effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data.

Results

In total, 31 studies were included (eight comparing acute WAD to controls, 14 comparing chronic WAD to controls, 12 comparing chronic NSNP to controls) comprising 4032 participants. Rectus capitis posterior major cross‐sectional area was smaller in people with chronic NSNP than controls (two studies: SMD –1.18 [95% confidence interval [CI] –1.65, –0.71]). The remaining meta‐analysis comparisons showed no group differences in MRI findings. The quality of evidence was mostly low due to small sample sizes and high heterogeneity.

Data Conclusion

Given the typically low‐quality evidence, definitive conclusions cannot be drawn on the presence of MRI findings in individuals with WAD or NSNP compared with pain‐free controls.

Level of Evidence: 3

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2018.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SKZbuY