title: Association between intervertebral disc degeneration and the Oswestry Disability Index.
abstract: BACKGROUND
  Low 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.
  
  
  OBJECTIVE
  To investigate the correlation of intervertebral disc degeneration (IDD) at lumbar levels L4/5 and L5/S1 and the Oswestry Disability Index (ODI).
  
  
  METHODS
  The 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).
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Increased 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.
authors.affiliation: Department of Nuclear Medicine, Goethe University, Frankfurt/Main, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Middendorp
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Goethe University, Frankfurt/Main, Germany.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Goethe University, Frankfurt/Main, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kollias
authors.affiliation: Department of Spine Surgery, Asklepios Clinic Lindenlohe, Lindenlohe, Schwandorf, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kafchitsas
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Goethe University, Frankfurt/Main, Germany.|Department of Nuclear Medicine, Goethe University, Frankfurt/Main, Germany.
authors.forename: M Fawad
authors.initials: MF
authors.lastname: Khan
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Goethe University, Frankfurt/Main, Germany.|Department of Nuclear Medicine, Goethe University, Frankfurt/Main, Germany.
authors.forename: Adel
authors.initials: A
authors.lastname: Maataoui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007403:Intervertebral Disc; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging*; D017116:Low Back Pain; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Lumbar spine; Oswestry Disability Index; intervertebral disc degeneration; low back pain; magnetic resonance imaging