Abstract
Background: Low back pain is a pervading problem that affects two thirds of adults at some time in their lives. The causes of low back ache are multiple including abnormalities of the lumbosacral spine or those related to the soft tissue surrounding the lumbosacral spine. Radiological imaging plays a key role in aiding to establish or rule out pathological conditions and most importantly to influence the therapeutic decision-making process.
Materials & Methods: The study was a prospective cross-sectional study which included 150 (based on available literature, with a confidence interval of 95% and an alpha error of 5%) consecutive patients who underwent MR and X ray imaging in King George Hospital for non-traumatic causes of low back ache over a period of 14 months from December 2017 to January 2019.
Results: The mean age of the patients included in the study was 39.5 years. The male to female ratio was 1.38:1. The Main chief complaint is low back ache (83%). Most common region involved is L4-L5 (81%). Most common x-ray finding is spondylolisthesis (45%). Multiple disc involvement is seen in 84% of cases on MRI.
Conclusion: The commonest age group affected by low back ache is 20-50-year. Plain radiography has a low sensitivity in detection of serious pathologies of the spine such as osteomyelitis and primary or secondary neoplasms. Magnetic resonance imaging serves as a non-invasive and highly sensitive method for evaluating the spine in the presence of low back pain.
References
1. Jarvik JG, Hollingworth W, Martin B, Emerson SS, Gray DT, Overman S et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA. 2003 Jun 4;289(21):2810-8.
- Kim SH, Bak KH, Kim DW, Kang TH. Primary intramedullary spinal sarcoma: a case report and review of the current literatures. J Korean Neurosurg Soc. Nov 2010;48(5):448-51.
- Modic T. Michael, Jeffrey S. Ross. Lumbar Degenerative Disk Disease. Radiology 2007:245,43-61.
- Smith AB, Soderlund KA, Rushing EJ, Smirniotopolous JG. Radiologic- Pathologic Correlation of Pediatric and Adolescent Spinal Neoplasms: Part 1, Intramedullary Spinal Neoplasms. AJR 2012; 198:34–43.
- Czervinke H: umnar IV disc disease. Neuroimag. Clin North Am 1993; 3:465486.
- Paajanen H, Erkintalo M, Kuusela et al. Resonance study of Disc degeneration in young low back pain patients: Spine 1989; 14:982-985.
- Ong, J Anderson, J Roche A pilot study of the prevalence of lumbar disc degeneration in elite athletes with lower back pain at the Sydney 2000 Olympic Games. Br J Sports Med 2003; 37:263–266.
- Cheung KM, Karppinen J, Chan D Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine 2009: 20;34(9):934-40.
- Takatalo J, Karppinen J, Niinimaki J, Taimela S, Nayha S, Jarvelin MR, Kyllonen E, Tervonen O, 2009 Prevalence of degenerative imaging findings in lumbar magnetic resonance imaging among young adults. Spine 2009 July 34(16):1716- 21.
- Savage RA, Whitehouse GH, Roberts N: The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain. Age and occupation in males. Eur spine J 1997; 6:106-114.
- Sivas Acar Filiz, Deniz Cılız, Uğur Erel, Esra Erkol Đnal, Kürsat Özoran, Bülent Sakman. Abnormal Lumbar Magnetic Resonance Imaging in Asymptomatic Individuals, 2009 Turk J Phys Med Rehab; 55:73-7.
- Matijsaitis V, Vaitkus A, Pauza V, et al. Neurosyphilis manifesting as spinal tranverse myelitis. Medicina Kaunas 2006;42(5):401–405.
- Weissleder Ralph, Wittenberg Jack, Harisinghani G. Mukesh. Primar of Diagnostic imaging, Third Edition, Copywrite ©2003, Mosby, Inc, Philadelphia, Pennsylvania pg 572-4.
- Dahnet Wolfgang. Radiology Review Manual 2007. 6th Edition, 2007 Lippincott Williams & Wilkins. Philadelphia, Pennsylvania. Central Nervous System. Disk degenerative disease; pg 202/3/24.
- Ducati LG, Silva MV, Brandão MM, Romero FR, Zanini MA. Intradural lumbar disc herniation: report of five cases with literature review. Eur Spine J. 2013 May;22 Suppl 3: S404-8. doi: 10.1007/s00586-012-2516-4. Epub 2012 Sep 27.
- Shobeiri E, Khalatbari MR, Taheri MS, Tofighirad N, Moharamzad Y. Magnetic resonance imaging characteristics of patients with low back pain and those with sciatica. Singapore medical journal. 2009 Jan; 50(1):87-93.
- Weishaupt D, Zanetti M, Hodler J, Boss N: MR imaging of the lumbar spine: Prevalence of intervertebral disc extrusion and sequestration. Nerve root compression, End plate abnormalities and Osteoarthritis of the facet joints in asymptomatic volunteers. Radiology 1998; 209:661-666.
- Modic MT, steinberg PM, Ross JS et at: Degenerative Disc Disease: Assessment of changes in vertebral body marrow with MR imaging. Radiology 1988; 166:193-199.
- Sharif SH: Role of MR imaging on the management of spinal infections. AJR 1992; 158:1333-45.
- Osborne AG; Tumors cysts and tumor like lesion of the spine and spinal cord. Diagnostic Neuroradiology 1994, Mosby Year book. Inc St Lousis Missouri.
Corresponding Author
Dr T. Savitri MD (RD)
Associate Professor, Department of Radio-Diagnosis, Andhra Medical College, Visakhapatnam
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.44
