Age appeared to influence the clinical expression of the disc–facet degenerative profile of the lumbar MRI-derived structural profiles in dentists, suggesting that lumbar MRI findings should be interpreted within a broader, age-sensitive clinical context rather than as isolated determinants of symptoms.
Abstract
Background/Objectives: Low back pain (LBP) is highly prevalent among dentists, although the relationship between lumbar magnetic resonance imaging (MRI) findings and symptoms remains unclear. This study aimed to identify lumbar MRI-derived structural profiles in actively practicing dentists and to examine their relationship with LBP, pain-related disability, demographic characteristics, occupational factors, and individual MRI findings. Methods: A cross-sectional observational study was conducted in 57 actively practicing dentists. Demographic, occupational, and clinical data were collected, and lumbar MRI examinations were performed using standardized protocols. MRI findings included disc bulging, disc herniation, annular fissure, Modic changes, osteophytes, facet joint degeneration, and spinal canal stenosis. Cluster analysis was used to identify MRI-derived structural profiles. Associations between profiles, LBP, disability, demographic characteristics, occupational factors, and individual MRI findings were assessed using chi-square tests and correspondence analysis. Results: Two distinct MRI-derived structural profiles were identified: a disc–facet degenerative profile (n = 38) and a non-osseous degeneration profile (n = 19). Disc bulging (100% vs. 52.6%, p < 0.001), facet joint degeneration (94.7% vs. 10.5%, p < 0.001), and osteophytes (23.7% vs. 0%, p = 0.022) significantly contributed to profile differentiation, whereas disc herniation, Modic changes, and annular fissure did not. Neither MRI-derived profile was associated with the presence of LBP or pain-related disability (p > 0.05). Younger dentists were more frequently classified within the disc–facet degenerative profile with LBP, whereas older dentists with similar structural findings were more commonly classified within the same profile without LBP (p = 0.007). No significant associations were observed between MRI-derived profiles and occupational characteristics. Conclusions: Two distinct lumbar MRI-derived structural profiles were identified in dentists, but neither was associated with LBP or pain-related disability. Age appeared to influence the clinical expression of the disc–facet degenerative profile, suggesting that lumbar MRI findings should be interpreted within a broader, age-sensitive clinical context rather than as isolated determinants of symptoms.
Higher MRI grades of lumbar degeneration were associated with greater functional disability in patients with LBP, and MRI grading may aid structural assessment in appropriately selected symptomatic patients, but findings should be interpreted in conjunction with clinical evaluation.
Dr. Avneet Kaur, Dr. Harish Gambhir, Dr. Noel Sukhjeet Singh et al.· Asian Journal of Medical Res...· 0 citations
Dgenerative lumbar spine disease is the predominant cause of chronic low back pain among patients undergoing MRI at Lagos State University Teaching Hospital, and MRI remains an indispensable diagnostic tool for identifying clinically significant spinal abnormalities.
A. Lawal, R. Akinola, A. Fasan-Odunsi et al.· Gateway Medical Journal· 0 citations
Background: Dentists are prone to work related musculoskeletal disorders (WMSDs) due to the use of prolonged static positions, repetition and poor ergonomics. These factors often cause neck and back pain, disability and loss of spinal mobility. Objective: The purpose of this study was to find out the prevalence of neck and back pain, the extent of disability and the assessment of cervical and lumbar mobility and to examine the relationship of these parameters with the various occupations of the dentists. Methods: The methods include a cross sectional, an observational study of 50 dentists aged 25-40 years. Neck and back pain were measured using the Numeric Pain Rating Scale (NPRS), disability was measured using the Neck Disability Index (NDI) and Oswestry Disability Index (ODI), and spinal mobility was measured using standardized clinical measurements. Analysis of data was done by descriptive and inferential statistics and at the 5% significance level. Results: 70% reported neck pain, 76% back pain. Most participants were minimally disabled (neck 66%, back 62%) and there was no severe disability. Less cervical mobility was noted and was significantly correlated with neck disability with the higher degree of disability correlating to less cervical mobility.
Conclusion: Dentists have high prevalence of work-related musculoskeletal disorders, but low rates of disability. Prevention of progression of musculoskeletal conditions and optimizing occupational health over the long term is a critical issue that requires early ergonomic interventions, posture correction, regular exercise, and workplace changes.
Lakshita Aggarwal, Bilal Ahmad, Karamjeet Kaur· International Journal For Mu...· 0 citations
Lumbar intervertebral disc degeneration (IVDD) is an important contributing factor for chronic low back pain. Recent evidence indicates that IVDD represents a "whole-organ" pathology involving multiple spinal structures, yet the relationships between structural magnetic resonance imaging (MRI) parameters remain incompletely characterised. This cross-sectional study included 100 patients with lumbar IVDD who underwent 3.0 T MRI. IVDD severity was graded using the Pfirrmann classification. Structural parameters including Modic changes, paraspinal muscle fat infiltration and facet joint degeneration were assessed independently by two radiologists. Statistical analyses included Spearman rank correlations, chi-square tests and logistic regression. Modic changes were present in 72% of patients and showed the strongest association with severe IVDD (Spearman r = 0.532, P < 0.001; χ² = 20.446, P < 0.001). Patients with Modic changes had 6.11-fold higher odds [95% CI: 2.81 – 13.28] of severe disc degeneration compared to those without. The prevalence of severe IVDD increased progressively from 21.4% in Grade 0 to 76.9% in Grade 3 Modic changes. Facet joint degeneration, present in 92%, correlated significantly with IVDD grade (r = 0.259, P = 0.009; OR = 1.83, 95% CI: 1.15 – 2.91). Paraspinal muscle fat infiltration, present in 64%, showed a weak, non-significant association with IVDD severity (r = 0.167, P = 0.097). Lumbar IVDD represents a complex "whole-organ" condition. Modic changes showed the strongest structural association with severe disc degeneration (r = 0.532, OR = 6.11), supporting a strong coupling between disc degeneration and endplate pathology. These findings reinforce the "three-joint complex" concept and have implications for comprehensive treatment strategies targeting multiple spinal structures .
M. Manoharan, Sharmila Aristotle, Jeffrey Skaria et al.· International Research Journ...· 0 citations
Aim: The relationship between lumbar intervertebral disc degeneration and paraspinal muscle degeneration remains controversial. Although previous studies have reported associations between disc degeneration and muscle atrophy and fatty infiltration, the effect of age on this relationship has not been sufficiently clarified. This study aimed to investigate the associations that cumulative and L4–L5 level-specific disc degeneration have with paraspinal muscle morphology, and to determine whether these associations persisted after adjustment for age. Materials and Methods: This retrospective cross-sectional study included 84 patients who underwent lumbar magnetic resonance imaging (MRI) for low back pain. Disc degeneration was evaluated at all lumbar levels according to the Pfirrmann classification, and the Total Pfirrmann Score was calculated. Relative functional cross-sectional area (rFCSA) and fatty infiltration (FI) measurements of the multifidus, erector spinae, and psoas muscles at the L4–L5 level were performed using ImageJ software. The relationships between variables were examined using Spearman correlation analysis. Multiple linear regression analysis was performed to investigate independent predictors. Age-controlled partial correlation analyses were also performed to evaluate the potential confounding effect of age. Results: Of the 84 patients included in the study, 48 (57.1%) were female and 36 (42.9%) were male, with a mean age of 42.3 ± 8.4 years. The mean Total Pfirrmann Score was 14.3 ± 3.8. A moderate positive correlation was found between age and the Total Pfirrmann Score (rho = 0.519; p < 0.001). Significant positive correlations were observed between the Total Pfirrmann Score and multifidus fatty infiltration (rho = 0.316; p = 0.003) and erector spinae fatty infiltration (rho = 0.300; p = 0.006). A weak negative correlation was detected between psoas rFCSA and the Total Pfirrmann Score (rho = −0.247; p = 0.023). Multifidus and erector spinae rFCSA were not significantly associated with the Total Pfirrmann Score (p = 0.094 and p = 0.095, respectively). At the L4–L5 level, higher Pfirrmann grade was associated with lower multifidus rFCSA (rho = −0.233; p = 0.033) and lower psoas rFCSA (rho = −0.319; p = 0.003), whereas the inverse association with erector spinae rFCSA was borderline (rho = −0.215; p = 0.050). Multiple linear regression analysis showed that age was the only statistically significant predictor of the Total Pfirrmann Score in the multivariable model (p < 0.001). After adjustment for age, the associations of multifidus FI (r = 0.193; p = 0.079) and erector spinae FI (r = 0.194; p = 0.078) with the Total Pfirrmann Score did not reach statistical significance. In the age-adjusted L4–L5 analysis, only the inverse association between Pfirrmann grade and psoas rFCSA remained statistically significant (r = −0.232; p = 0.034). Conclusions: Greater cumulative lumbar disc degeneration was associated with increased fatty infiltration of the multifidus and erector spinae muscles and lower psoas rFCSA, whereas multifidus and erector spinae rFCSA were not associated with the Total Pfirrmann Score. At L4–L5, greater disc degeneration was associated with lower multifidus and psoas rFCSA, while the association with erector spinae rFCSA was borderline. After adjustment for age, the associations of multifidus and erector spinae fatty infiltration with cumulative disc degeneration were attenuated and did not reach statistical significance; however, a weak independent association cannot be excluded.
Background: Intervertebral Differential Dynamics (IDD) Therapy is used as a targeted, non-surgical decompression intervention for selected patients with disc-related spinal pain. A previously published cohort reported significant short-term improvements in pain and disability, while paired magnetic resonance imaging (MRI) outcomes were reserved for subsequent analysis.
Objective: To evaluate paired MRI findings and clinical outcomes following IDD Therapy in adults with MRI-confirmed cervical or lumbar disc bulges and herniations.
Methods: This retrospective secondary analysis included 21 adults with 47 treated disc levels who completed a 30-session protocol. Previously published Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) outcomes were linked to paired MRI measurements. Posterior disc contour extension, canal anteroposterior diameter, and disc height were analyzed separately for 14 lumbar and 7 cervical index lesions. Radiographic response and exploratory clinical-imaging correlations were also evaluated.
Results: Mean VAS improved from 5.8 to 1.5 and ODI from 18.5 to 6.5 in the parent cohort. Lumbar mean changes were -1.75 mm for disc contour extension, +1.31 mm for canal diameter, and +0.64 mm for disc height; cervical mean changes were -1.20 mm, +0.89 mm, and +0.53 mm, respectively. All region-specific changes were statistically significant. Global radiographic improvement was observed in 16 of 21 patients and 34 of 47 treated levels. Disc contour reduction was strongly associated with VAS improvement (r=0.95; 95% CI, 0.88-0.98; P<0.001).
Conclusions: Completion of IDD Therapy was associated with substantial clinical improvement and favorable paired-MRI changes in most patients in this selected cohort. Because the study was retrospective, lacked a comparator, used non-standardized clinical imaging, and included only treatment completers, the findings are hypothesis-generating rather than causal.
Tyler Maitland Graham, John Graham· Journal of physical medicine...· 0 citations
