Does lumbar MRI predict degree of disability in patients with degenerative disc disease? A prospective cross-sectional study at University of Gondar comprehensive specialized hospital, North West Ethiopia, 2020

Background Low back pain (LBP) is one of the most serious public health problem globally with substantial socioeconomic implications. Degenerative disc disease is an important cause of LBP in the elderly. Magnetic resonance imaging (MRI) is routinely ordered by physicians in evaluation of patients with suspected degenerative disc disease in the lumbar spine. However there is no unanimous agreement in the literatures when it comes to the association of degree of disability to that of severity of lumbar MRI findings. Objective The aim of this study is to assess the association between degree of disability measured using Oswestry Disability Index (ODI) and findings on lumbar spine MRI in patients with degenerative disc disease at University of Gondar comprehensive Specialized Hospital, North West Ethiopia, 2020. Methods and materials A prospective cross-sectional study was conducted on 72 consecutively enrolled patients with degenerative disc disease who underwent lumbar MRI scan. Degree of disability was measured using ODI questionnaire translated to local language. Association between lumbar spine MRI parameters and ODI score and category was tested using Spearman's rank correlation coefficient and Chi square tests. Results The mean age of the study subjects was 43.81 +/- 1.88 years (range 22-83 years). Forty-three (59.7%) of the study population were female. In terms of ODI category, most fell under minimal 33 (45.8%) or moderate 25 (34.7%) disability. Disc bulge (81.9%) and foraminal stenosis were the most frequent MRI abnormalities detected. ODI score showed weak correlation with grade of spinal canal stenosis. Grade of foraminal stenosis showed no correlation with ODI score. Conclusion The clinical relevance of MRI findings in predicting degree of disability in patients with degenerative disc disease is limited and MRI study should be sparingly ordered in evaluation of these patients particularly in resource constrained settings.

Automated summary

This study aimed to assess the association between the degree of disability measured using the Oswestry Disability Index (ODI) and findings on lumbar spine MRI in patients with degenerative disc disease. The results showed that there is limited clinical relevance of MRI findings in predicting the degree of disability in these patients. MRI studies should be sparingly ordered, especially in resource-constrained settings.