Scoliosis is the most common deformity of the spine, and the incidence of back pain in AIS ranges from 32% - 85%. Although it is considered that AIS can cause pain in the spine, this connection with regard to the scientific evidence is not entirely clear.
Aim: The aim of this study was to determine the relationship of morphological changes of intervertebral segments analyzed by MRI in patients with AIS and pain, and also its impact on patients functional status and quality of life.
Method: The study included 120 patients diagnosed with AIS based on radiographic examination. Patients underwent MRI (1.5-T) of the thoracic and lumbar spine. SN were detected, and the degree of disc degeneration was classified using the Pfirrmann grading system. Patients filled out VAS, the ODI for back pain and questionnaire SRS-22r.
Results: The incidence of pain in AIS is 68.3%, and the largest number of participants experienced mild pain. Statistically significant association of DD in lumbar spine with the occurrence of pain was shown, but only at the fourth degree of DD according to Pfirrmann classification. The incidence of SN were 35%. Patients with SN were 4 times more likely to have pain, and 3,5 times higher intensity of pain scaled according to VAS. In addition, a distinct correlation with DD classified according to Pfirrmann that is more pronounced at high-grade DD was found. There is an independent connection of the female sex with poorer functional status, measured by the ODI, and quality of life, measured by the questionnaire SRS-22r.
Conclusion: Morphological changes of the intervertebral disc like SN and DD can be one of the factors that cause back pain in AIS. It should be remembered that the presence of DD, especially if it is low-grade, is not enough to confirm the etiology of pain. We also found a distinct correlation of SN and high-grade DD, and a significantly higher intensity of pain in patients with SN. The association between SN and DD may stress the importance of the endplate on the pathogenesis of the degenerative changes in the intervertebral disc
