SCIENTIFIC ARTICLE Do more MRI findings imply worse disability or more intense low back pain? A cross-sectional study of candidates for lumbar disc prosthesis Linda Berg & Christian Hellum & Øivind Gjertsen & Gesche Neckelmann & Lars Gunnar Johnsen & Kjersti Storheim & Jens Ivar Brox & Geir Egil Eide & Ansgar Espeland & The Norwegian Spine Study Group Received: 11 April 2013 /Revised: 12 July 2013 /Accepted: 22 July 2013 /Published online: 28 August 2013 # ISS 2013 Abstract Objective To examine whether combined magnetic resonance imaging (MRI) findings are related to the degree of disability and low back pain (LBP) in candidates for lumbar disc pros- thesis surgery. Materials and methods This cross-sectional study included 170 disc prosthesis candidates (mean age 41 years; 88 women) with chronic non-radicular LBP and localized disc degeneration. Experienced radiologists rated Modic changes and disc findings at L4-S1 on pre-treatment MRIs. An MRI total score (0–10) for findings at L4/L5 plus L5/S1 was calculated for Modic type I and/or II changes, a posterior high intensity zone (HIZ) in the disc, dark/black nucleus pulposus signal, and ≥40 % disc height decrease. We analyzed the relationship of the MRI total score to the Oswestry Disability Index (ODI) (n =170) and LBP intensity scores (0–100 visual analogue scale, n =165) using multiple linear regression and adjusting for age, gender, body mass index, smoking, and anxiety/depression. Additional investigators of the Norwegian Spine Study Group who participated in the study are listed in the ‘‘Appendix.’’ L. Berg : G. Neckelmann : A. Espeland (*) Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, 5021 Bergen, Norway e-mail: ansgar.espeland@helse-bergen.no L. Berg e-mail: linda.berg@kir.uib.no G. Neckelmann e-mail: gesche.neckelmann@helse-bergen.no L. Berg : A. Espeland Section for Radiology, Department of Clinical Medicine, University of Bergen, Bergen, Norway C. Hellum : J. I. Brox Department of Orthopaedics, Oslo University Hospital, Oslo, Norway C. Hellum e-mail: christian.hellum@medisin.uio.no J. I. Brox e-mail: jbrox@ous-hf.no C. Hellum Department of Orthopaedics, University of Oslo, Oslo, Norway Ø. Gjertsen Section of Neuroradiology, Oslo University Hospital, Oslo, Norway e-mail: oegjert@gmail.com L. G. Johnsen National Centre for Diseases of the Spine, University Hospital of Trondheim, Trondheim, Norway e-mail: lars.gunnar.johnsen@ntnu.no L. G. Johnsen Orthopaedic Department, University Hospital of Trondheim, Trondheim, Norway K. Storheim NAR, Department of Orthopaedics and Communication- and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway e-mail: kjersti.storheim@medisin.uio.no K. Storheim Department of Health Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway G. E. Eide Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway e-mail: geir.egil.eide@helse-bergen.no G. E. Eide Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Skeletal Radiol (2013) 42:1593–1602 DOI 10.1007/s00256-013-1700-x