Abstract
Introduction
According to previous studies, the presence of disk degeneration based on MRI and its association with low back pain (LBP) remains questionable. However, such studies were not population-based and/or entailed various methodological limitations, and should be interpreted with caution. Therefore, as part of the largest radiographic and clinical population-based study of the lumbar spine, this study addressed the association of disk degeneration as noted on MRI with the presence and severity of LBP.
Materials and Methods
Sagittal T2-weighted MRIs of the lumbar spine were obtained of 2702 adult Southern Chinese. Radiographic evaluation entailed the presence of disk degeneration based on the Schneiderman et al criteria. An overall degenerative disk disease score (range: 0 to 15) was obtained and represented the global severity of disk degeneration. Additional assessment of spine pathology/abnormalities, LBP, visual analog scale (VAS) pain scores, and subject demographics were performed. Based on various modifiable and nonmodifiable risk factors associated with LBP, a LBP profile was assessed.
Results
There were 1614 females and 1088 males (mean age = 42 years). A low back profile was identified, noting younger individuals, females, and Modic changes to be highly associated with the reporting of LBP and although there was an increasing trend of workload severity associated with LBP it was not a significant factor. Individuals with disk degeneration had a higher prevalence and increased likelihood of LBP than individuals without disk degeneration (OR: 1.45; 95% CI, 1.12–1.87; p2 = 0.95) and LBP (DDD = 0 (ref), adjusted OR = 1.4 at 1 to 2 DDD; OR = 1.7 at 3 to 4 DDD; OR = 2.0 at 5 to 6 DDD; OR = 3.4 at >7 DDD; p). Further subgroup analysis suggested that the association of disk degeneration with LBP may be demographically influenced (e.g., age).
Conclusion
This large-scale study noted that disk degeneration based on MRI is significantly associated with LBP. The “global severity” of disk degeneration was found to increase the risk of having LBP. These findings support that the study of disk degeneration on MRI is clinically relevant. In addition, a LBP profile in a Chinese population was established.
Yes
None declared