Korelasi antara Sacral Slope dengan Pola Degenerasi Diskus dan Perubahan Endplate Vertebra Lumbal Berdasarkan Pemeriksaan MRI

Benanda Ami Akhsan, Dr. dr. Bambang Supriyadi, Sp. Rad, Subsp. MSK (K), MM.; dr. Evi Artsini, Sp. Rad, Subsp. TR (K)

2026 | Tesis | S2 Kedokteran Klinik

Latar belakang: Low back pain merupakan masalah muskuloskeletal yang sering berkaitan dengan degenerasi diskus intervertebralis dan perubahan endplate vertebra lumbal. Sacral slope sebagai parameter spinopelvic alignment berperan dalam distribusi beban aksial, lumbar lordosis, dan shear stress lumbosakral, sehingga diduga berhubungan dengan pola degenerasi diskus serta perubahan endplate pada MRI. Pemeriksaan MRI memungkinkan penilaian morfologi diskus, derajat degenerasi berdasarkan Pfirrmann grading dan perubahan endplate.

Tujuan: Mengetahui korelasi antara sacral slope dengan pola degenerasi diskus dan perubahan endplate vertebra lumbal berdasarkan pemeriksaan MRI.

Metode: Penelitian ini merupakan penelitian korelatif dengan desain cross- sectional menggunakan data retrospektif. Populasi terjangkau adalah pasien low back pain yang menjalani pemeriksaan MRI lumbal di RSUP Dr. Sardjito Yogyakarta periode 1 Januari-31 Desember 2025. Sampel diambil dari pasien yang memenuhi kriteria inklusi dan eksklusi. Analisis dilakukan terhadap nilai sacral slope, pola degenerasi diskus, dan perubahan endplate vertebra lumbal.

Hasil: Rerata usia subjek 44,5 ± 14,4 tahun, sebanyak 54,0?rjenis kelamin perempuan, rerata indeks massa tubuh 24,8 ± 3,6 kg/m², dan 84,0% tidak memiliki penyakit sistemik. Reliabilitas interobserver sangat baik untuk pengukuran sacral slope (ICC = 0,994) serta sempurna untuk penilaian degenerasi diskus dan perubahan endplate (Kappa = 1,000). Tidak terdapat korelasi signifikan antara sacral slope dan pola degenerasi diskus intervertebralis lumbal (r = -0,106; p =0,464). Korelasi antara sacral slope dan perubahan endplate juga tidak signifikan dengan arah negatif lemah (r = -0,202; p = 0,160).

Kesimpulan: Sacral slope tidak berkorelasi signifikan dengan pola degenerasi diskus intervertebralis maupun perubahan endplate vertebra lumbal pada MRI pasien low back pain.

Background: Low back pain is a musculoskeletal issue frequently associated with intervertebral disc degeneration and lumbar vertebral endplate changes. As a spinopelvic alignment parameter, sacral slope plays a role in axial load distribution, lumbar lordosis, and lumbosacral shear stress; thus, it is hypothesized to be associated with disc degeneration patterns and endplate changes observed on MRI. MRI allows for the assessment of disc morphology, the degree of degeneration based on Pfirrmann grading, and endplate changes.

Objective: To determine the correlation between sacral slope and lumbar disc degeneration patterns and vertebral endplate changes based on MRI.

Methods: This was a correlational study with a cross-sectional design using retrospective data. The accessible population consisted of patients with low back pain who underwent lumbar MRI at Dr. Sardjito General Hospital, Yogyakarta, between January 1 and December 31, 2025. Samples were selected from patients meeting the inclusion and exclusion criteria. Analyses were performed on sacral slope values, disc degeneration patterns, and lumbar vertebral endplate changes.

Results: The mean age of the subjects was 44.5 ± 14.4 years; 54.0% were female, the mean body mass index was 24.8 ± 3.6 kg/m², and 84.0% had no systemic diseases. Interobserver reliability was excellent for sacral slope measurement (ICC

= 0.994) and perfect for the assessment of disc degeneration and endplate changes (Kappa = 1.000). There was no significant correlation between sacral slope and disc degeneration patterns (r = -0.106; p = 0.464). The correlation between sacral slope and endplate changes was also not significant, showing a weak negative trend (r = -0.202; p = 0.160).

Conclusion: Sacral slope does not significantly correlate with disc degeneration patterns or lumbar vertebral endplate changes on MRI in patients with low back pain.

Kata Kunci : Low Back Pain, Intervertebral Disc Degeneration, Magnetic Resonance Imaging, Lumbar Vertebrae, Spine