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. 2018 Oct 31:11:2687-2698.
doi: 10.2147/JPR.S162988. eCollection 2018.

Magnetic resonance imaging analysis of work-related chronic low back pain: comparisons of different lumbar disc patterns

Xin Jiang  1 , Dong Chen  1
Affiliations

Magnetic resonance imaging analysis of work-related chronic low back pain: comparisons of different lumbar disc patterns

Xin Jiang et al. J Pain Res. .

Abstract

Background: Currently, there is a lack of comparative research about different lumbar disc patterns in patients with work-related chronic low back pain (CLBP) based on magnetic resonance imaging (MRI) analysis. Therefore, this study, on different patterns of lumbar disc degeneration or herniation in patients with CLBP, is valuable. In this study, we retrospectively investigated lumbar degenerative changes in patients with CLBP by using MRI analysis.

Materials and methods: Two hundred and eighty-three patients (110 women and 173 men) with work-related CLBP were enrolled and divided into four groups based on intervertebral disc morphology from MRI analysis, including normal discs (ND) group, degenerative discs (DD) group, bulging discs (BD) group, and herniated discs (HD) group. Demographic characteristics, occupational information, Visual Analog Scale (VAS) scores, and Oswestry Disability Index (ODI) scores were analyzed. Moreover, multiple parameters were investigated in the MRI analysis.

Results: The mean age of all 283 patients was 41.8±12.0 years (range, 18-80) and the mean duration of CLBP for all patients was 24.5±24.9 months. There were no significant differences in the patients' BMI, history of smoking, and education level (P>0.05). The three most common occupational types were manual worker, desk worker, and technician. The VAS and ODI scores of patients with CLBP in the DD, BD, and HD groups were significantly higher than those of patients in the ND group (P<0.05). The degrees of degeneration of L4/5 and L5/S1 were significantly higher than those of other intervertebral discs (P<0.05). The disc heights of L4/5 in the BD and HD groups were significantly lower than those of the ND group (P<0.05) and the disc height of L5/S1 in the HD group was significantly lower than that of the ND group (P<0.05). At the neutral position, the distances of L3/4, L4/5, and L5/S1 discs' bulge/herniation in the BD and HD groups were significantly higher than those in the ND and DD groups (P<0.05).

Conclusion: In summary, more severe degenerative changes of lower lumbar discs (L4/5 and L5/S1) such as higher degree of degeneration of disc, lower disc height, and significant displacement of disc were found in patients with work-related CLBP based on MRI analysis.

Keywords: bulging discs; chronic low back pain; degenerative discs; herniated discs; magnetic resonance imaging analysis.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
VAS of patients with CLBP in the four groups. Notes: Data were presented as mean ± SD and P<0.05 was considered statistically significant. *P<0.05 vs ND group. Abbreviations: BD, bulging discs; CLBP, chronic low back pain; DD, degenerative discs; HD, herniated discs; ND, normal discs; VAS, Visual Analog Scale.
Figure 2
Figure 2
ODI of patients with CLBP in the four groups. Notes: Data were presented as mean ± SD and P<0.05 was considered statistically significant. *P<0.05 vs ND group; **P<0.05 vs DD group; #P<0.05 vs BD group. Abbreviations: BD, bulging discs; CLBP, chronic low back pain; DD, degenerative discs; HD, herniated discs; ND, normal discs; ODI, Oswestry Disability Index.
Figure 3
Figure 3
Degrees of degeneration of lumbar discs in all 283 patients with chronic low back pain based on Pfirrmann classification. Notes: Data were presented as mean ± SD and P<0.05 was considered statistically significant. *P<0.05 vs L1/2; **P<0.05 vs L2/3; #P<0.05 vs L3/4 group.
Figure 4
Figure 4
Degrees of degeneration of lumbar discs in different groups. Notes: Data were presented as mean ± SD and P<0.05 was considered statistically significant. *P<0.05 vs L1/2; **P<0.05 vs L2/3; #P<0.05 vs L3/4 group; aP<0.05 vs ND group; bP<0.05 vs DD group. Abbreviations: BD, bulging discs; DD, degenerative discs; HD, herniated discs; ND, normal discs.
Figure 5
Figure 5
T12-S1 Global Cobb angle of lumbar lordosis.
Figure 6
Figure 6
T12-S1 Global Cobb angle of lumbar lordosis. Notes: Data were presented as mean ± SD and P<0.05 was considered statistically significant. *P<0.05 vs DD group. Abbreviations: BD, bulging discs; DD, degenerative discs; GCA, Global Cobb angle; GCAe, GCA at the extension position; GCAf, GCA at the flexion position; GCAn, GCA at the neutral position; HD, herniated discs; ND, normal discs.
Figure 7
Figure 7
Anterior and posterior vertebral height.
Figure 8
Figure 8
Slipping distance of spondylolisthesis at the neutral, flexion, and extension position.
Figure 9
Figure 9
Mid-disk height of the intervertebral discs (A) in four groups (B). Notes: Data were presented as mean ± SD and P<0.05 was considered statistically significant. *P<0.05 vs ND group; **P<0.05 vs DD group. Abbreviations: BD, bulging discs; DD, degenerative discs; DHL1, disc height of L1/2; DHL2, disc height of L2/3; DHL3, disc height of L3/4; DHL4, disc height of L4/5; DHL5, disc height of L5/S1; HD, herniated discs; ND, normal discs.
Figure 10
Figure 10
Distances of T12-S1 discs’ bulge/herniation at the neutral, flexion, and extension position.
Figure 11
Figure 11
Anteroposterior (AP) diameter of spinal canal at disc level in the neutral, flexion, and extension position.
Figure 12
Figure 12
Translational motion (L1-S1).
See this image and copyright information in PMC

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