Correlation between Pain, Disability and Levels of Disc Herniation in Michigan State University Grade-3 Disc Prolapsed Patients using Magnetic Resonance Imaging: A Cross-sectional Study

Introduction: Sciatica is considered as a pain with radiation from the back to the dermatome of the nerve root which gets compressed. Clinical decision making for the diagnosis and treatment of the patients with sciatica need the support from the imaging of the spine. Magnetic Resonance Imaging (MRI) is the best modality for screening the spine.

Aim: To identify the relationship between pain, disability and levels of disc herniation in grade-3 disc prolapsed patients.

Materials and Methods: The present study was a cross-sectional study, which was conducted in the King Khalid Hospital, Hail, Saudi Arabia from November 2019 to May 2020. In this study, 57 patients were included and their consent was obtained. Patients reported their intensity of back and leg pain in Visual Analogue Scale (VAS) and recorded their disability in the Roland Morris Disability Questionnaire (RMDQ-Arabic version). Clinical examination of the spine and the lower extremity was done, followed by MRI for all the patients. The degree of the disc displacement and nerve root compression was graded according to the Michigan State University (MSU) classification of disc herniation. Documented data was statistically analysed using Statistical Package for the Social Sciences (SPSS) 20.0 version with the Pearson’s correlation.

Results: Correlation between the pain intensity (VAS), Functional Disability (RMDQ) and grade-3 disc herniation in MRI were measured with Pearson correlation coefficient. Grade-3 disc herniation had weak correlation with pain intensity (r=-0.147) and also with functional disability (r=0.155). In these patients, pain intensity and functional disability also showed weak correlation disability (r=0.293).

Conclusion: Level of the disc herniation shows weak correlation with both intensity of pain and functional disability; thus, it is advisable to correlate the clinical symptom of the patients with MRI to decide the therapeutic intervention.