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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(02): 334-340
DOI: 10.1055/s-0041-1735831
Artigo Original
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Is There Any Association between the Severity of Disc Degeneration and Low Back Pain?[*]

Article in several languages: português | English
Guilherme Augusto Foizer 
1   Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
2   Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
,
Vagner Cleyton de Paiva 
3   Clínica Avançada de Ortopedia e Traumatologia (CAORT), São Paulo, SP, Brasil
,
Rodrigo Domingues do Nascimento 
2   Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
,
Carlos Gorios 
2   Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
,
Alberto Cliquet Júnior 
4   Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
,
João Batista de Miranda 
4   Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
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Abstract

Objective To access the possibility that higher degrees of disc degeneration lead to higher levels of pain and dysfunction.

Methods Magnetic resonance imaging (MRI) scans of 85 patients with low back pain lasting for more than 12 weeks were evaluated, and the degree of disc degeneration was quantified according to the Pfirrmann grading system. The Pfirrmann degree in each disc space from L1-L2 to L5-S1, the maximum degree of Pfirrmann (Pfirrmann-max) between the lumbar discs, and the sum of Pfirrmann (Pfirrmann-sum) degrees were correlated (through the Spearman test) with the Oswestry Disability Index (ODI) and the Visual Analogical Scale (VAS) for pain.

Results In total, 87% of the patients had moderate to severe lumbar disc degeneration measured by Pfirrmann-max, and the most degenerated discs were L4-L5 and L5-S1. There was a week to moderate correlation regarding the Pfirrmann-max (r = 0,330; p = 0.002) and the Pfirrmann-sum (r = 0,266; p = 0,037) and the ODI, and the Pfirrmann scores in L1-L2 were correlated with the ODI and the VAS.

Conclusion Patients with chronic idiopathic low back pain frequently have moderate to severe lumbar disc degeneration, which has a negative impact on the quality of life of the patients. Low degrees of degeneration in L1-L2 might be related with higher degrees of pain and of functional disability.

Keywords

spine - quality of life - magnetic resonance imaging - low back pain - intervertebral disc

Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Study developed at the Spine Outpatient Clinic of Hospital Geral de Carapicuíba, Carapicuíba, SP, Brazil.




Publication History

Received: 06 November 2020

Accepted: 07 April 2021

Article published online:
25 October 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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