Association of subcutaneous adiposity with MRI findings in youth patients with low back pain

Abstract

Purpose To evaluate whether lumbar disk pathology and vertebral body endplate changes are associated with dorsal subcutaneous thickness (DST) in young adults with low back pain. Methods Retrospectively lumbar MRI examinations of young adults (18-35 years old) performed between April and June 2019 were analyzed. Patients with onset of low back pain within the last six months without history of trauma were included. All patients were divided into three groups according to dorsal subcutaneous thickness: Group 1 (DST <10mm); Group 2 (DST 10-20mm); Group 3 (DST >20mm). Vertebral body endplate changes and intervertebral disk degeneration were evaluated using Modic and Pfirrmann classification. Displacement of disc material beyond the interspace was classified using lumbar disc nomenclature: version 2.0 Results Eighty patients (42 males and 38 females, mean age of 29) met the criteria. Group 1 consisted of 23, Group 2 of 27 and Group 3 of 30 patients. Vertebral body endplate changes were observed in only 8 patients (8/80, 10%), evenly distributed in all groups. Advanced intervertebral disk degeneration (grade IV and V) was dominant in Group 1 and 2, 47% each. In contrast, 43% (13/30) of the patients in Group 3 had normal signal intensity and only 19% advanced lumbar disk degeneration. In Group 3 half of the patients had normal undisplaced disks 50% (15/30) and less than one third disk herniation 30% (9/30). On the contrary in Group 2 almost half of the patients had disk herniation 48% (13/27) and only 37% (10/27) of the patients had normal undisplaced disks. Conclusion Lumbar disk pathology is associated with subcutaneous adiposity in young adults with low back pain.