Oswestry Disability Index scores correlate with MRI measurements in degenerating intervertebral discs and endplates

Abstract

Background: Low back pain (LBP) is a widespread problem and the leading cause of disability worldwide. While the cause of LBP is multifactorial, several studies suggested that inflammatory mediators in damaged subchondral plates of degenerating discs may lead to chemical sensitization and mechanical stimulation, eventually causing pain. The goal of this study was to explore associations between such changes and LBP-related disability using dynamic contrast-enhanced MRI. Methods: Thirty-two patients diagnosed with nonspecific LBP and 24 healthy control subjects were studied with dynamic contrast-enhanced (DCEMRI) MRI and T1r (spin-lattice relaxation in the rotating frame) acquisitions. DCEMRI enhancement in disc endplate regions and average T1ρ measurements in the nucleus pulposus were extracted. The LBP patients were grouped based on their Oswestry Disability Index (ODI) scores and associations between MRI measurements and ODI scores were analyzed. Results: Significant associations were found between ODI scores and DCEMRI enhancement in the cartilaginous endplate regions of the most degenerated discs. ODI scores also correlated with T1ρ measurements in the nucleus pulposus of degenerating discs. Conclusions: DCEMRI enhancement in the cartilaginous endplate regions and lower T1ρ measurements in the nucleus pulposus (NP) were associated with greater disability that is related to low back pain as reported on the ODI. This complements earlier reports suggesting a link between LBP and endplate degeneration. Further studies are needed to validate these findings. Significance: Our findings indicated that dynamic contrast-enhanced MRI signal enhancement in the cartilaginous endplate regions were associated with greater disability related to low back pain. This signal enhancement might be an indication of inflammatory changes in disc endplate regions. Therefore, advanced quantitative imaging techniques like the ones presented in this study might be needed to complement conventional radiological evaluations to identify the subset of patients who could potentially benefit from novel therapies directed towards treating the disc endplate regions. | 347ARPINAR et Al.

Evaluation of health related quality of life with the use of Oswestry disability index in degenerative discogenic low back pain

“…Various studies reported that this self-administered questionnaire was reproducible, constant, valid, and very useful in assessing disability in patients complaining of LBP due to disc disease and had a response rate of 100%. Although ODI score could not assess pain directly, it offered an idea by evaluating the disability level due to LBP [23,24]. There was a strong correlation between ODI and VAS in patients with disc herniation which was consistent with Hasanović-Vučković et al [25] and was inconsistent with Bajpai et al [26] and Corniola et al [27] A statistically significant difference was seen between ODI and clinical parameters (p < 0.05).…”

Outcomes of epidural steroids following percutaneous transforaminal endoscopic discectomy: a meta-analysis and systematic review

“…However, the difficulty in maintaining employment, unemployment, and economic status are highly influential when deciding to return to work after an operation. Many studies have used the ODI in assessing the degree of dysfunction in patients with LDH [ 27 , 28 ]. Our study did not find a statistically significant difference in postoperative ODI scores between the epidural steroid group and the normal saline group.…”

Analgesic effect of epidural anesthesia via the intervertebral foramen approach in percutaneous transforaminal endoscopic discectomy: a retrospective study

“…Similar results have been found in other studies, with EA reported as being superior to LA for SAP [ 8 , 12 – 14 , 23 ]. ODI is used widely to evaluate the degree of functional dysfunction in patients with LBP [ 26 ]. In this study, there were no significant intergroup differences in postoperative ODI scores, indicating that LTEA did not cause any more dysfunction than LA in the waist region.…”