Associations between MRI changes of degenerative lumbar spine and Oswestry Disability Index in patients with chronic...

Chronic low back pain (CLBP) is a leading cause of morbidity. MRI studies have linked CLBP to various degenerative changes in the lumbar spine, but a clear correlation remains uncertain. This study explores MRI findings in the lumbosacral spine and their relationship with the Oswestry Disability Index (ODI) in patients with CLBP.

This cross-sectional study included participants with CLBP who visited the spine clinic and were prescribed a lumbosacral spine MRI between June 2023 and August 2024 in a tertiary care center in Nepal. These patients completed questionnaires for the ODI and the Numerical Pain Rating Scale to assess back pain. The lower three lumbar levels degenerative findings were classified according to the standard classification system. Data were analyzed to determine correlations between these degenerative MRI findings and disability due to back pain. The ODI was categorized into two groups, and logistic regression analysis was performed to identify demographic and MRI-related factors predicting the disability.

MRI analysis included 300 discs from 100 participants (mean age: 39.9 ± 10.82 years, male: female = 51:49) focused on the L3/L4, L4/L5, and L5/S1 levels. The most common finding was disc herniation (63%), followed by disc degeneration (Pfirrmann's grade ≥3) (47.67%), foraminal stenosis (36%), facet joint arthritis (32%), lumbar canal stenosis (19.67%), and Schmorl's nodes (10.33%). Logistic regression analysis showed female gender, presence of Schmorl's nodes at L5/S1, and L5/S1 facet joint arthritis significantly predicted the disability.

Disc herniation and disc degeneration are the most frequently observed MRI findings in patients with CLBP, but they do not correlate with disability due to low back pain. Female gender, the presence of Schmorl's nodes at L5/S1, and L5/S1 facet joint arthritis are significant predictors of disability due to CLBP.