Relationship between lumbar disc degeneration on MRI and low back pain: A cross-sectional community study

Abstract

Purpose: Although an association has been suggested between disc degeneration (DD) and low back pain (LBP), some DD is thought to be an age-related change unrelated to symptoms. Age-inappropriate DD, however, may be associated with LBP. The purpose of this study was to investigate whether there is a difference in LBP and LBP-related quality of life between age-appropriate and age-inappropriate DD, as assessed by magnetic resonance imaging (MRI).

Participants and methods: In this cross-sectional study, degenerative change in the lumbar intervertebral discs of 382 subjects (age range, 27-82 years) was evaluated by MRI. Degenerative Disc Disease (DDD) scores were assigned using the Schneiderman classification, as the sum of grades for all intervertebral levels (0-15). We classified subjects into three groups according to age and DDD score: Low DD (mild DD relative to age), Appropriate (age-appropriate DD), and High DD (severe DD relative to age). We compared the three groups in terms of LBP prevalence, LBP intensity, LBP-specific quality of life (QOL) according to the Roland-Morris Disability Questionnaire (RDQ), and the Short Form-36 Item Health Survey (SF-36).

Results: Of 382 subjects, there were 35% in the Low DD group, 54% in the Appropriate group, and 11% in the High DD group. There were no significant differences among the groups in terms of prevalence of LBP, LBP intensity, RDQ score, or SF-36 score.

Conclusion: No association was found between age-inappropriate DD (Low or High DD group) and age-appropriate DD (Appropriate group) in terms of prevalence of LBP, LBP intensity, RDQ, or SF-36.

Keywords: age-related; cross-sectional study; disc degeneration; low back pain.

Fig. 1.

Participants and exclusion criteria A questionnaire survey and physical examination were administered to community residents, and lumbar spine MRI imaging was performed. After applying the exclusion criteria, 382 patients were included in the analysis.

Fig. 2.

Classification based on age and disc degeneration Participants were graded according to age and DDD score (center panels) and then assigned into the following three groups using the table on the right: Low DD, Appropriate, and High DD.