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Disc degeneration combined with end plate signal change and Schmorls' node highly associated with LBP
Disc degeneration alone was not found to have much impact on lower back pain; however, researchers found disc degeneration was highly associated with low back pain when combined with endplate signal change or Schmorl node.
In a cross-sectional patient study, the researchers examined the association between disc degeneration (DD) and low back pain (LBP), in consideration with endplate signal change (ESC) and Schmorl node (SN), using the MRIs of 975 patients recruited from two regions of Japan. Patients’ mean age was 66.4 years.
The researchers used sagittal T-2 weighted images to assess DD, ESC and SN at all intervertebral levels from C2-C3 to L5-S1, with assessments of the L1-L2 to L5-S1 lumbar region included in the study. Additionally, an independent orthopedic surgeon assessed DD grading using the Pfirrmann classification system.
Results showed DD alone was present in 30.4% of the patients’ scans; ESC alone was found in 0.8%, and SN alone was present in 1.5%. The researchers observed DD and ESC in 26.6% of the patients; DD and SN in 12.3%; and DD, ESC and SN in 19.1%.
Although DD alone was not associated with LBP, the combination of DD, ESC and SN at the L1-L2, L4-L5 and L5-S1 was found to have a significant association with LBP. LBP was also significantly associated with the combination of DD and ESC at the L3-L4, L4-L5 and L5-S1 regions, according to the researchers. – by Robert Linnehan
Disclosures: Teraguchi reports receiving a Grant-in-Aid for Young Scientists, B26861206, which is paid directly to the institution. Please see the full study for a list of all other authors’ relevant financial disclosures.