Correlation Between the Degree of Disc Degeneration and the Degree of Facet Joint Arthritis in Spinal Magnetic Resonance Imaging (MRI) and Oswestry Disability Index (ODI) Scores at Wahidin Sudirohusodo General Hospital, Makassar

Abstract

Objective: The primary aim of this study is to assess the correlation between the degree of disc degeneration and the degree of facet joint arthritis in spinal MRI examinations and the functional status of patients using the Oswestry Disability Index (ODI) score.

Methods: This observational analytic study employed a cross-sectional design, utilizing secondary data from medical records at Wahidin Sudirohusodo Hospital, Makassar. The total sample comprised 55 respondents, collected from January 2023 to March 2024, who met the inclusion criteria. Inclusion criteria included patients with MRI findings of disc degeneration and facet joint arthritis in the lumbosacral vertebrae, aged over 40 years. Exclusion criteria involved patients with non-lumbosacral vertebrae pain sources, pain due to trauma, infection, occupation, smoking, and spinal tumor metastasis, as well as congenital abnormalities.

Results: The degree of facet joint arthritis was assessed based on Pathria's classification, while disc degeneration was evaluated using Pfirrmann's classification on spinal MRI. Correlations between disc degeneration and facet joint arthritis, as well as their respective correlations with functional status based on the ODI, were analyzed.

On univariate analysis, this study showed that at lumbar level 1-2 the most found is 3rd degree disc degeneration at 43.9%. Respondents with minimal disabilities experienced grade II disc degeneration the most at 43.03%, meanwhile respondents with moderate disabilities experienced grade III degeneration the most at 41,79%.

Bivariate analysis was done in this study, the degree of disc degeneration at each level of lumbar vertebrae have significant correlations with facet joint arthritis with a p value <0.05 with a very strong positive correlation indicated by a correlation coefficient value of 0.938 in level of lumbal 1-2, but does not have a significant relationship with the functional degree with a p value of >0.05. Body mass index did not have a significant relationship to disc degeneration with value p of 0.217. Occupation has a significant relationship to disc degeneration with grades p of 0.002, with a weak positive correlation indicated by a correlation coefficient value of 0.047. Gender has a significant relationship to disc degeneration with value p of 0.014.

From multivariate analysis, there is no significant relationship between the age group variables 41-50, 51-60, 61-70, 71-80, 81-90 on the incidence of grade II-IV disc degenerations (P value >0,05). There was also no significant relationship between normal body mass index, overweight, obese 1, obese 2 with grade II-IV disc degenerations (P value >0,05). Female respondents were more likely to suffer from grade II disc degeneration (P 0,036; OR 7.8) and grade III (P 0,034; OR 8) compared to men. There is no significant correlation between disc degeneration (Pfirrmann grade 2-5) and moderate disability as measured by ODI (P values of 0.532, 0.673, 0.465), nor between facet joint arthritis (Pathria classification) and moderate disability (P values of 0.897, 0.979). Similar results were found for severe disability, with no significant correlation between disc degeneration and severe disability (P values of 0.417, 0.776, 0.272), nor between facet joint arthritis and severe disability (P values of 0.151, 0.978).

Conclusion: This study found a significant correlation between disc degeneration and facet joint arthritis with a strong positive correlation coefficient between the two variables at the lumbar 4-5 level. However, no significant correlation was found between disc degeneration and functional status, nor between facet joint arthritis and functional status, based on the Oswestry Disability Index. Correlations were found between gender, age, body mass index, and activity level with disc degeneration, with female respondents more likely to suffer from grade II and grade III disc degeneration compared to males.