Skip to main content

Advertisement

SpringerLink
Log in

Correlation of pain, functional impairment, and health-related quality of life with radiological grading scales of lumbar degenerative disc disease

  • Clinical Article - Spine
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

It is generally believed that radiological signs of lumbar degenerative disc disease (DDD) are associated with increased pain and functional impairment as well as lower health-related quality of life (HRQoL). Our aim was to assess the association of the Modic and Pfirrmann grading scales with established outcome questionnaires and the timed-up-and-go (TUG) test.

Methods

In a prospective two-center study with patients scheduled for lumbar spine surgery, visual analogue scale (VAS) for back and leg pain, Roland-Morris Disability Index, Oswestry Disability Index and HRQoL, as determined by the Short-Form (SF)-12 and the Euro-Qol, were recorded. Functional mobility was measured with the TUG test. Modic type (MOD) and Pfirrmann grade (PFI) of the affected lumbar segment were assessed with preoperative imaging. Uni- and multivariate logistic regression analysis was performed to estimate the effect size of the relationship between clinical and radiological findings.

Results

Two hundred eighty-four patients (mean age 58.5, 119 (42 %) females) were enrolled. None of the radiological grading scales were significantly associated with any of the subjective or objective clinical tests. There was a tendency for higher VAS back pain (3.48 vs. 4.14, p = 0.096) and lower SF-12 physical component scale (31.2 vs. 29.4, p = 0.065) in patients with high PFI (4–5) as compared to patients with low PFI (0–3). In the multivariate analysis, patients with MOD changes of the vertebral endplates were 100 % as likely as patients without changes to show an impaired TUG test performance (odds ratio (OR) 1.00, 95 % confidence interval (CI) 0.56–1.80, p = 0.982). Patients with high PFI were 145 % as likely as those with low PFI to show an impaired TUG test performance (OR 1.45, 95 % CI 0.79–2.66, p = 0.230).

Conclusions

There was no association between established outcome questionnaires of symptom severity and two widely used radiological classifications in patients undergoing surgery for lumbar DDD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Arana E, Marti-Bonmati L, Vega M, Bautista D, Molla E, Costa S, Montijano R (2006) Relationship between low back pain, disability, MR imaging findings and health care provider. Skelet Radiol 35:641–647

    Article  Google Scholar 

  2. Behrend C, Prasarn M, Coyne E, Horodyski M, Wright J, Rechtine GR (2012) Smoking cessation related to improved patient-reported pain scores following spinal care. J Bone Joint Surg Am 94:2161–2166

    Article  PubMed  Google Scholar 

  3. Berg L, Hellum C, Gjertsen O, Neckelmann G, Johnsen LG, Storheim K, Brox JI, Eide GE, Espeland A, Norwegian Spine Study G (2013) Do more MRI findings imply worse disability or more intense low back pain? A cross-sectional study of candidates for lumbar disc prosthesis. Skelet Radiol 42:1593–1602

    Article  Google Scholar 

  4. Endean A, Palmer KT, Coggon D (2011) Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila Pa 1976) 36:160–169

    Article  Google Scholar 

  5. Fishbain DA, Lewis JE, Gao J, Cole B, Steele Rosomoff R (2009) Are chronic low back pain patients who smoke at greater risk for suicide ideation? Pain Med 10:340–346

    Article  PubMed  Google Scholar 

  6. Gautschi OP, Corniola MV, Joswig H, Smoll NR, Chau I, Jucker D, Stienen MN (2015) The timed up and go test for lumbar degenerative disc disease. J Clin Neurosci 22:1943–1948

    Article  PubMed  Google Scholar 

  7. Gautschi OP, Corniola MV, Schaller K, Smoll NR, Stienen MN (2014) The need for an objective outcome measurement in spine surgery–the timed-up-and-go test. Spine J 14:2521–2522

    Article  PubMed  Google Scholar 

  8. Gautschi OP, Corniola MV, Smoll NR, Joswig H, Schaller K, Hildebrandt G, Stienen MN (2015) Sex differences in subjective and objective measures of pain, functional impairment and health-related quality of life in patients with lumbar degenerative disc disease. Pain in press

  9. Gautschi OP, Smoll NR, Corniola MV, Joswig H, Chau I, Hildebrandt G, Schaller K, Stienen MN (2015) Validity and reliability of a measurement of objective functional impairment in lumbar degenerative disc disease: the Timed-up-and-Go (TUG) test. Neurosurgery in press

  10. Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199

    Article  CAS  PubMed  Google Scholar 

  11. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976) 26:1873–1878

    Article  CAS  Google Scholar 

  12. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148

    Article  CAS  PubMed  Google Scholar 

  13. Sigmundsson FG, Kang XP, Jonsson B, Stromqvist B (2011) Correlation between disability and MRI findings in lumbar spinal stenosis: a prospective study of 109 patients operated on by decompression. Acta Orthop 82:204–210

    Article  PubMed Central  PubMed  Google Scholar 

  14. Sorlie A, Moholdt V, Kvistad KA, Nygaard OP, Ingebrigtsen T, Iversen T, Kloster R, Solberg TK (2012) Modic type I changes and recovery of back pain after lumbar microdiscectomy. Eur Spine J 21:2252–2258

    Article  PubMed Central  PubMed  Google Scholar 

  15. Stienen MN, Richter H, Prochnow N, Schnakenburg LF, Gautschi OP (2011) Does smoking correlate with low back pain and the outcome of spinal surgery? Z Orthop Unfall 149:317–323

    CAS  PubMed  Google Scholar 

  16. Stienen MN, Smoll NR, Hildebrandt G, Schaller K, Gautschi OP (2014) Influence of smoking status at time of surgery for herniated lumbar disk on postoperative pain and health-related quality of life. Clin Neurol Neurosurg 122:12–19

    Article  PubMed  Google Scholar 

  17. Suthar P, Patel R, Mehta C, Patel N (2015) MRI evaluation of lumbar disc degenerative disease. J Clin Diagn Res 9:TC04–TC09

    PubMed Central  PubMed  Google Scholar 

  18. Vining RD, Potocki E, McLean I, Seidman M, Morgenthal AP, Boysen J, Goertz C (2014) Prevalence of radiographic findings in individuals with chronic low back pain screened for a randomized controlled trial: secondary analysis and clinical implications. J Manip Physiol Ther 37:678–687

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Cornelia Lüthi (study nurse of the Department of Surgery, Cantonal Hospital St. Gallen) and Dario Jucker (medical student of the University of Zurich) for their important contribution in the collection of data that are reported in this article.

Author information

Authors and Affiliations

  1. Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland

    M.-V. Corniola, M. N. Stienen, K. Schaller & O. P. Gautschi

  2. Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland

    H. Joswig & G. Hildebrandt

  3. Department of Neurology, John Hunter Hospital, Newcastle, Australia

    N. R. Smoll

  4. Service de Neurochirurgie, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland

    M.-V. Corniola

Authors
  1. M.-V. Corniola
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. N. Stienen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Joswig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. R. Smoll
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Schaller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Hildebrandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. O. P. Gautschi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M.-V. Corniola.

Ethics declarations

Funding

No funding was received for this research.

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Corniola, MV., Stienen, M.N., Joswig, H. et al. Correlation of pain, functional impairment, and health-related quality of life with radiological grading scales of lumbar degenerative disc disease. Acta Neurochir 158, 499–505 (2016). https://doi.org/10.1007/s00701-015-2700-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-015-2700-5

Keywords

Search

Navigation