Intervertebral disc degeneration on MRI is associated with low back pain: a population-based study

Abstract

INTRODUCTION: The presence of disc degeneration based on MRI and its association with low back pain (LBP) remains under heated debate. As part of the largest radiographic and clinical population-based study of the lumbar spine, this study addressed the association of disc degeneration as noted on MRI with the presence and severity of LBP. METHODS: Sagittal T2-weighted MRIs of the lumbar spine were obtained of 2,702 adult individuals of Southern Chinese origin. The presence and severity of lumbar disc degeneration was assessed. An overall degenerative disc disease (DDD) score (range: 0 to 15) was obtained. Additional assessment of spine pathology/abnormalities, LBP, VAS pain scores, and subject demographics were performed. RESULTS: There were 1,614 females and 1,088 males (mean age=42 years). Individuals with disc degeneration had a higher prevalence of LBP (p<0.001). VAS pain scores were significantly higher in individuals with disc degeneration (p<0.001). DDD scores were significantly greater in individuals with LBP (p<0.001). Logistic regression modeling noted a significant quadratic trend (r2=0.95) increased association of disc degeneration severity and LBP (p<0.001). CONCLUSION: This large-scale study noted that disc degeneration based on MRI is significantly associated with LBP. The “global severity” of disc degeneration was found to increase the risk of having LBP. These findings support that the study of disc degeneration on MRI is clinically relevant, and that treatment strategies, such as biological therapies, that can reduce degeneration can also diminish the incidence of LBP.