• Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Ömer Orhun, Veli Umut Turgut, and M Necmettin Pamir.
• Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey. Electronic address: muratsakireksi@gmail.com.
• Clin Neurol Neurosurg. 2020 Nov 1; 198: 106120.

ObjectiveWe aimed to develop a new scoring system for spinal degeneration including Modic changes, fatty infiltration (fi) in the paraspinal muscles, and intervertebral disc degeneration (IVDD), briefly Mo-fi-disc, using current radiological classification systems. We also aimed to understand whether Mo-fi-disc could predict patients with more intense low back pain (LBP).Patients And MethodsWe conducted a cross-sectional analysis of a retrospective database between March 2018 and July 2020. We evaluated patients in terms of Modic changes, fatty infiltration in the paraspinal muscles, and IVDD at all lumbar levels on lumbar spine MRI. We grouped patients based on their LBP intensity. Visual analog scale (VAS) scores were used for LBP intensity.ResultsWe evaluated 134 patients (female: 66, male: 68; mean age: 35.44 ± 6.5 years). Patients with higher VAS scores had significantly higher 'Mo-disc' scores and higher 'fi' scores compared to those with lower VAS scores (3.54 ± 2.7 vs. 2.55 ± 2.8, p = 0.0075; 6.85 ± 3.2 vs. 5.25 ± 2.9, p = 0.0092). Patients with higher VAS scores had significantly higher 'Mo-fi-disc' scores compared to those with lower VAS scores (10.4 ± 4.2 vs. 7.94 ± 3.8, p = 0.0003). The most significant predictor for patients with higher VAS scores was 'Mo-fi-disc' scoring system with an OR of 1.193 (95 % CI: 1.055-1.349, p = 0.005).ConclusionPatients with more intense LBP had higher 'Mo-fi-disc' scores. This scoring system suggests an easy and objective classification to evaluate the spinal degeneration.Copyright © 2020 Elsevier B.V. All rights reserved.

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