Lumbar disc degenerative disease and lumbar stenosis: a correlation between the MRI findings and disability among low back pain patients using oswestry disability index in hospital Serdang, Malaysia
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242914Keywords:
Disc degeneration, Low back pain, Lumbar stenosis, MRI, Oswestry disability indexAbstract
Background: Low back pain is a major global disability affecting all ages and nations, costing more than coronary heart disease, diabetes, alzheimer's, and renal illnesses. Research has shown no significant correlation between MRI results and patient symptoms, highlighting the need for further investigation.
Methods: A retrospective descriptive and analytical cross-sectional study was done at Hospital Serdang. From January 2017 to December 2018, data was collected retrospectively. Secondary data came from eHIS, RIS, and PACS. The data collecting forms recorded age, race, gender, oswestry disability index score, disc prolapse, and AP/SCA measures. Pearson Chi-Square and Fisher's exact tests found relationships between independent categorical variables. Pearson and Spearman's correlations determined the link between two numerical variables. We compared numerical variables, one categorical variable, and two groups using an independent T-test and a Mann-Whitney U-test. We defined statistical significance as p-value <0.05.
Results: This research covered 104 patients. Hospital Serdang sees more women than men aged 30-39 with low back pain. According to the Oswestry Disability Index (ODI), patients' pain levels are most concerning and standing is most irritating. It found no correlation between MRI results (disc prolapsed and lumbar stenosis) and patient impairment (ODI score). However, patient age is significantly correlated with disc prolapse. Previous research found similar results.
Conclusions: The study confirms previous MRI findings that disc degeneration and lumbar stenosis do not correlate with patient impairments, but reveal a significant correlation between disc prolapse and patient age, possibly due to structural and anatomical differences.
References
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67.
Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007;25(2):353-71.
Milette PC. Degenerative Disc Disease. Rivista di Neuroradiologia. 2003;16(5):759-61.
Kjaer P, Leboeuf-Yde C, Sorensen JS, Bendix T. An epidemiologic study of MRI and low back pain in 13-year-old children. Spine. 2005;30(7):798-806.
Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84(1):95-103.
Goni VG, Hampannavar A, Gopinathan NR, Singh P, Sudesh P, Logithasan RK, Sharma A, Shashidhar BK, Sament R. Comparison of the oswestry disability index and magnetic resonance imaging findings in lumbar canal stenosis: an observational study. Asian Spine J. 2014;8(1):44.
Suthar P, Patel R, Mehta C, Patel N. MRI evaluation of lumbar disc degenerative disease. JCDR. 2015;9(4):TC04.
Iizuka Y, Iizuka H, Mieda T, Tsunoda D, Sasaki T, Tajika T, et al. Prevalence of chronic nonspecific low back pain and its associated factors among middle-aged and elderly people: an analysis based on data from a musculoskeletal examination in Japan. Asian Spine J. 2017;11(6):989.
Miller JA, Schmatz C, Schultz AB. Lumbar disc degeneration: correlation with age, sex, and spine level in 600 autopsy specimens. Spine. 1988;13(2):173-8.
Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Ame J Neuroradiol. 2015;36(4):811-6.
Kanayama M, Togawa D, Takahashi C, Terai T, Hashimoto T. Cross-sectional magnetic resonance imaging study of lumbar disc degeneration in 200 healthy individuals. J Neurosurg: Spine. 2009;11(4):501-7.
Ali HI, Saleh A. Lumbar spine MRI axial loading in patients with degenerative spine pathologies: Its impact on the Radiological findings and treatment decision. Egypt J Radiol Nucl Medi. 2015;46(4):1065-9.
Thomé C, Börm W, Meyer F. Degenerative lumbar spinal stenosis: current strategies in diagnosis and treatment. Deutsc Ärzteblatt Int. 2008;105(20):373.
Hiwatashi A, Danielson B, Moritani T, Bakos RS, Rodenhause TG, Pilcher WH, et al. Axial loading during MR imaging can influence treatment decision for symptomatic spinal stenosis. Ame J Neuroradiol. 2004;25(2):170-4.
Hazard RG, Bendix A, Fenwick JW. Disability exaggeration as a predictor of functional restoration outcomes for patients with chronic low-back pain. Spine. 1991;16(9):1062-7.
Danielson KK, Moffitt TE, Caspi A, Silva PA. Comorbidity between abuse of an adult and DSM-III-R mental disorders: evidence from an epidemiological study. Am J Psych. 1998;155(1):131-3.
Skaf GS, Ayoub CM, Domloj NT, Turbay MJ, El-Zein C, Hourani MH. Effect of age and lordotic angle on the level of lumbar disc herniation. Advances in orthopedics. 2011;2011(1):950576.
Sirvanci M, Bhatia M, Ganiyusufoglu KA, Duran C, Tezer M, Ozturk C, et al. Degenerative lumbar spinal stenosis: correlation with Oswestry Disability Index and MR imaging. Europ Spine J. 2008;17:679-85.
