Pattern of Disc Degeneration Impacts Low Back Pain

Contiguous, multilevel disc degeneration increases likelihood of lower back pain, pain severity

WEDNESDAY, April 11 (HealthDay News) -- Contiguous, multilevel disc degeneration (CMDD) is associated with increased likelihood of low back pain (LBP) and pain severity compared with skipped level disc degeneration (SLDD), according to a study published in the April 1 issue of Spine.

To investigate the clinical relevance of SLDD compared with that of CMDD of the lumbar spine, Kenneth M.C. Cheung, M.D., M.B.B.S., of the University of Hong Kong, and colleagues conducted a cross-sectional radiographic and clinical evaluation of 3,099 Chinese patients. A total of 1,457 patients with multilevel disc degeneration of the lumbar spine on T2-weighted magnetic resonance imaging were stratified into SLDD (301 patients) or CMDD (1,156 patients). Based on the relative location of nondegenerated normal discs to degenerated disc levels, SLDD was further classified into five types from I (least severe) to V (most severe).

The researchers found that, compared with SLDD, CMDD was associated with an increased likelihood of historical LBP (odds ratio [OR], 1.39) and pain severity (OR, 1.83). Increasing severity of SLDD type correlated with a significant increasing trend of number of levels of disc degeneration, disc degeneration severity, and presence of disc bulges/extrusions. In SLDD type V there was a higher prevalence of LBP and higher pain intensity. There was no difference in functional disability scores between CMDD and SLDD or within SLDD types.

"Our study suggests that subjects with a similar degree but different patterns of multilevel disc degeneration do differ with respect to low back symptoms," the authors write. "This finding may provide new evidence with regard to the mechanism of LBP."

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