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Papers of the Week

2022 Apr

Rev Bras Ortop (Sao Paulo)



Is There Any Association between the Severity of Disc Degeneration and Low Back Pain?


Foizer G A, de Paiva V C, do Nascimento R D, Gorios C, Cliquet Júnior A, de Miranda J B
Rev Bras Ortop (Sao Paulo). 2022 Apr; 57(2):334-340.
PMID: 35652022.


 To access the possibility that higher degrees of disc degeneration lead to higher levels of pain and dysfunction.  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.  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;  = 0.002) and the Pfirrmann-sum (r = 0,266;  = 0,037) and the ODI, and the Pfirrmann scores in L1-L2 were correlated with the ODI and the VAS.  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.