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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Modic and Pfirrmann grading scales are not associated with symptom severity in patients suffering from lumbar degenerative disc disease

Meeting Abstract

  • Marco-V. Corniola - Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland
  • Martin N. Stienen - Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland; Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
  • Nicolas R. Smoll - Department of Neurology, John Hunter Hospital, Newcastle, Australia
  • Karl Schaller - Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland
  • Oliver P. Gautschi - Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.04.05

doi: 10.3205/16dgnc253, urn:nbn:de:0183-16dgnc2532

Veröffentlicht: 8. Juni 2016

© 2016 Corniola et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: 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 objective functional impairment (OFI).

Method: 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. OFI was measured using the timed-up-and-go (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: 284 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 OFI (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 OFI (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.