Document Type : Research Article
Low backache is commonly experienced via adults during their lives. Though it is caused by degenerative changes, spinal stenosis, neoplasm, infection and trauma, lumbar disc degeneration is most commonly diagnosed abnormality associated. As Magnetic Resonance Imaging (MRI) is non-invasive imaging technique with excellent spatial and contrast resolution, it has become the investigation of choice in assessment of patients with low back pain. This study was designed to determine the styles of degenerative disc disease on MRI in patients with low backache.
Methods: A retrospective hospital-based study was performed at Department of Radiodiagnosis of DR.B.V.P. Rural Medical College, PIMS (DU), Loni, Maharashtra, India. by reviewing MRI reports of 210 patients who underwent MRI of lumbar spine for complaint of chronic low back pain, radicular pain, neurogenic claudication or various other signs and symptoms suggestive of lumbar degenerative disc disease from 6 months. The patients having MRI findings of acute spinal infection, recent trauma, tumors, spinal dysraphism and metabolic conditions were excluded from the study.
Results: Out of the 210 patients included in the study, 120 patients (60%) were male and 90 patients (40%) were female. The mean age of the study population was 45.29 ±18.89 (14-85) years. Multiple contiguous level disc disease turned into the most common type of involvement which was noted in 105 (52%) patients. Grade 4 lumbar disc degeneration (graded as per category given by Pfirrmann et al) was noted in 63.3% (135) cases followed by Grade 2 in 28.2% (55) cases and Grade 1in 5% (10) cases. The maximum common involvement was observed at L4-L5 level (80%) and L5-S1 levels (56.8%) followed by L3-L4 (33.9%) in decreasing order of frequency. The most common class was disc bulge noted in 49.5% (95) of cases. Nerve root compression was observed in 58% (115) of the total cases. Nerve root compromise was also noted most frequently compressing L5 nerve (29.32% of cases). Annular tear was observed in 16.20% (30) of cases and among them 20% (5) of cases had torn at intervertebral discs. It is most frequently noted involving L4-L5 intervertebral disc (75.5% of cases), followed by L5-S1 (24.5% of cases).