title: The usefulness of radiological grading scales to predict pain intensity, functional impairment, and health-related quality of life after surgery for lumbar degenerative disc disease.
abstract: The goal of this study is to determine the relationship of radiological grading scales of lumbar degenerative disc disease (DDD) with postoperative pain intensity, functional impairment, and health-related quality of life (HRQoL).
  
  
  
  Response to surgical treatment at 6 weeks (W6) on the visual analogue scale (VAS) for back and leg pain, Oswestry-Disability (ODI) and Roland-Morris Disability Index (RMDI), Timed Up and Go (TUG) test, EuroQol (EQ) 5D, and Short-Form Health-Survey (SF-12) physical component summary (PCS) was compared between patients with different Modic (MOD) and Pfirrmann (PFI) grades. Longitudinal outcomes at day 3 (D3), W6, 6 months (M6), and 1 year (Y1) were compared.
  
  
  
  The study included 338 patients (mean age, 58.6 years), of which n = 202 (59.8%) had MOD 1-3 and n = 217 (64.2%) PFI 4-5 changes. Patients with MOD 1-3 were as likely as patients without MOD changes to be treatment-responders at W6 in terms of VAS leg pain, ODI, RMDI, TUG, EQ5D, and SF-12 PCS. Similarly, patients with PFI 4-5 were as likely as patients with PFI 1-3 changes to be treatment-responders at W6. Longitudinal outcomes were similar at D3, W6, M6, and Y1 between patients with and without MOD changes. Patients with PFI 4-5 fared similar to those with PFI 1-3 except for inferior HRQoL on the SF-12 PCS metric at Y1.
  
  
  
  There was no distinct relationship between commonly used radiological grading scales of lumbar DDD with clinical outcome. Therefore, no prognosis should be made on the grounds of preoperative PFI and MOD classifications for patients undergoing spine surgery for lumbar DDD.
authors.affiliation: Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland. ogautschi@gmail.com.|Service de Neurochirurgie, Département des neurosciences cliniques, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, 1205, Geneva, Switzerland. ogautschi@gmail.com.
authors.forename: Oliver P
authors.initials: OP
authors.lastname: Gautschi
authors.affiliation: Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland.|Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
authors.forename: Martin N
authors.initials: MN
authors.lastname: Stienen
authors.affiliation: Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
authors.forename: Holger
authors.initials: H
authors.lastname: Joswig
authors.affiliation: Department of Neurology, John Hunter Hospital, Newcastle, Australia.
authors.forename: Nicolas R
authors.initials: NR
authors.lastname: Smoll
authors.affiliation: Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland.
authors.forename: Karl
authors.initials: K
authors.lastname: Schaller
authors.affiliation: Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland.
authors.forename: Marco V
authors.initials: MV
authors.lastname: Corniola
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011788:Quality of Life
keywords: Degenerative disc disease; Health-related quality of life; Modic type; Pfirrmann score; Timed Up and Go test