Prevalence of benign osseous lesions of the spine and association with spinal pain in the general population in whole body MRI

PLoS One. 2019 Sep 9;14(9):e0219846. doi: 10.1371/journal.pone.0219846. eCollection 2019.

Abstract

Background: Benign osseous lesions of the spine are common but precise population prevalence estimates are lacking. Our study aimed to provide the first population-based prevalence estimates and examine association with back and neck pain.

Materials and methods: We used data from the population-based Study of Health in Pomerania (SHIP). Whole-body MRI examinations (1.5 Tesla: T1, T2, and TIRM weightings) were available from 3,259 participants. Readings of the spinal MRI images were conducted according to a standardized protocol by a single reader (JS). The intra-rater reliability was greater than Kappa values of 0.98. Pain measures included the seven-day prevalence of spine pain and neck pain, and average spine pain intensity due to spine pain during the past three months.

Results: We found 1,200 (36.8%) participants with at least one osseous lesion (2,080 lesions in total). Osseous lesions were less common in men than in women (35.5% vs 38.9%; P = .06). The prevalence of osseous lesions was highest at L2 in both sexes. The prevalence of osseous lesions increased with age. Up to eight osseous lesions were observed in a single subject. Hemangioma (28%), and lipoma (13%) occurred most often. Sclerosis (1.7%), aneurysmal bone cysts (0.7%), and blastoma (0.3%) were rare. Different osseous lesions occurred more often in combination with each other. The association with back or neck pain was mostly negligible.

Conclusion: Osseous lesions are common in the general population but of no clinical relevance for spinal pain. The prevalence of osseous lesions varied strongly across different regions of the spine and was also associated with age and gender. Our population-based data offer new insights and assist in judging the relevance of osseous lesions observed on MRIs of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Back Pain / diagnostic imaging
  • Back Pain / epidemiology
  • Back Pain / pathology
  • Back Pain / physiopathology*
  • Bone Cysts, Aneurysmal / diagnostic imaging*
  • Bone Cysts, Aneurysmal / epidemiology
  • Bone Cysts, Aneurysmal / pathology
  • Cervical Vertebrae / diagnostic imaging*
  • Cervical Vertebrae / innervation
  • Cervical Vertebrae / pathology
  • Female
  • Germany / epidemiology
  • Hemangioma / diagnostic imaging*
  • Hemangioma / epidemiology
  • Hemangioma / pathology
  • Humans
  • Lipoma / diagnostic imaging*
  • Lipoma / epidemiology
  • Lipoma / pathology
  • Lumbar Vertebrae / diagnostic imaging*
  • Lumbar Vertebrae / innervation
  • Lumbar Vertebrae / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neck Pain / diagnostic imaging
  • Neck Pain / epidemiology
  • Neck Pain / pathology
  • Neck Pain / physiopathology*
  • Observer Variation
  • Prevalence
  • Reproducibility of Results
  • Sclerosis
  • Sex Factors

Grants and funding

SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant No. 03ZIK012), the Ministry of Cultural Affairs as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania. Whole-body MR imaging was supported by a joint grant from Siemens Healthcare, Erlangen, Germany and the Federal State of Mecklenburg-Vorpommern. The University of Greifswald is a member of the 'Center of Knowledge Interchange' program of the Siemens AG. Dynamic contrast-enhanced MR mammography research is part of the entire whole-body MRI study and was supported by Bayer Healthcare. Prof Maher’s fellowship is funded by Australia’s National Health and Medical Research Council.