• Marcus Middendorp, Thomas J Vogl, Konstantinos Kollias, Konstantinos Kafchitsas, M Fawad Khan, and Adel Maataoui.
• Department of Nuclear Medicine, Goethe University, Frankfurt/Main, Germany.
• J Back Musculoskelet Rehabil. 2017 Jan 1; 30 (4): 819-823.

BackgroundLow back pain and lumbar intervertebral disc degeneration (IDD) are common findings. Valid data on correlation between clinical pain scores and grades of IDD are not available.ObjectiveTo investigate the correlation of intervertebral disc degeneration (IDD) at lumbar levels L4/5 and L5/S1 and the Oswestry Disability Index (ODI).MethodsThe lumbar discs L4/5 and L5/S1 of 591 patients were evaluated according to the 5-point (Grade I to Grade V) grading system as published by Pfirrmann et al. Functional status was assessed using the Oswestry Disability Index. Spearman's coefficient of rank correlation was used for statistical analysis (p < 0.05).ResultsThe majority of patients revealed lumbar discs with Pfirrmann grade II to grade IV changes (93.3% at level L4/5; 89.8% at level L5/S1), while a relatively low percentage of lumbar discs presented with grade I (level L4/5: 1.5%; level L5/S1: 2.0%) or grade V (level L4/5: 5.1%; level L5/S1: 8.1%) changes, respectively. Patients' ODI scores ranged between 0 and 91.11% (arithmetic mean of 32.77% ± 17.02%). The largest group of patients (48.39%) had moderate functional disability (ODI score between 21 and 40%). There was a weak, but statistically significant positive correlation between IDD and ODI for both evaluated lumbar levels.ConclusionsIncreased lumbar IDD in MRI goes along with an increased ODI. Thus, MRI is a strong indicator of a patient's clinical appearance. However, low back pain cannot be explained by imaging alone. Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.

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