Frequency of Lumber Disc Degenerative Diseases in Patients with and Without Radiculopathy and Low Back Pain Using Magnetic Resonance Imaging

Khadija  Zafar; Narjis  Batool; Abid  Ali; Nosheen  Arshad; Waqar Mahmood  Dar; Adrash  Naeem

doi:10.54393/pbmj.v5i1.279

Authors

Khadija Zafar University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Narjis Batool University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Abid Ali Department of Allied Health Sciences, The University of Lahore, Gujrat Campus
Nosheen Arshad University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Waqar Mahmood Dar University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus
Adrash Naeem University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat Campus

DOI:

https://doi.org/10.54393/pbmj.v5i1.279

Keywords:

Disc Degenerative Disease, MRI Lumber, Disc Herniation, Low Back Pain, Radiculopathy

Abstract

Degenerative lumbar disc disease is a condition in which an intervertebral disk and surrounding spinal components are weakened. This might be due to age or a pathogenic cause. Individuals may complain of low back pain. Objective: To determine the pattern of lumbar spine and disc degenerative diseases amongst patients having or not having Low Back Pain with or without radiculopathy diagnosed on Magnetic Resonance Imaging. Methods: Data was collected following inclusion criteria using convenient sampling technique. A total of 266 Patients undergone Lumber MRI scans on MRI Machine 1.5T Phillips. Data was collected from Radiology Department of Tertiary Care Hospital in Lahore, Pakistan. Data was entered and analyzed on SPSS version 20. Age Groups, Gender frequencies were mentioned. Cross Tabulation of Lumber Disc Degenerative Diseases with age and Gender was done and Chi square was applied. P-value ≤0.05 was considered significant. Results: The most prevalent age group for disc degeneration was 40-59 having 56.8 %. Females with disc degeneration have the highest frequency of 143 (53.8%) while males were 123 (48.2%). Lumber Disc degeneration was 101 (38%), Disc Herniation 54 (20.3%), and last with lowest presence of Spinal Canal Stenosis 18 (6.8%). Patients with Radiculopathy with Low back Pain was 61 (22.93%) and only LBP was the most common between the patients having 205 (77.1%). Cross Tabulation of Age Groups with Lumber Disc Pathologies was Significant having P value 0.05. Conclusion: In conclusion MRI can detect Disc Degeneration, Disc Herniation & Buldges, and Spinal Canal Stenosis & Nerve Root Compression. It can be considered significant and accurate to avoid any other interventional procedures. It is also concluded the LBP is an important factor in Disc Degenerative changes & radiculopathy is less seen.

References

Suthar P, Patel R, Mehta C, Patel N. MRI evaluation of lumbar disc degenerative disease. Journal of clinical and diagnostic research: JCDR. 2015;9(4):TC04.

https://doi.org/10.7860/JCDR/2015/11927.5761

Peng Y, Lv F-J. Symptomatic versus asymptomatic intervertebral disc degeneration: is inflammation the key? Critical Reviews™ in Eukaryotic Gene Expression. 2015;25(1).

https://doi.org/10.1615/CritRevEukaryotGeneExpr.2015012369

Brinjikji W, Diehn F, Jarvik J, Carr C, Kallmes DF, Murad MH, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. American Journal of Neuroradiology. 2015;36(12):2394-2399.

https://doi.org/10.3174/ajnr.A4498

Liu C, Cai H-X, Zhang J-F, Ma J-J, Lu Y-J, Fan S-W. Quantitative estimation of the high-intensity zone in the lumbar spine: comparison between the symptomatic and asymptomatic population. The Spine Journal. 2014;14(3):391-396.

https://doi.org/10.1016/j.spinee.2013.06.078

Farshad-Amacker NA, Farshad M, Winklehner A, Andreisek G. MR imaging of degenerative disc disease. European journal of radiology. 2015;84(9):1768-1776.

https://doi.org/10.1016/j.ejrad.2015.04.002

Kushchayev SV, Glushko T, Jarraya M, Schuleri KH, Preul MC, Brooks ML, et al. ABCs of the degenerative spine. Insights into imaging. 2018;9(2):253-274.

https://doi.org/10.1007/s13244-017-0584-z

Witwit WA, Kovac P, Sward A, Agnvall C, Todd C, Thoreson O, et al. Disc degeneration on MRI is more prevalent in young elite skiers compared to controls. Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26(1):325-332.

https://doi.org/10.1007/s00167-017-4545-3

Elfering A, Semmer N, Birkhofer D, Zanetti M, Hodler J, Boos N. Young investigator award 2001 winner: Risk factors for lumbar disc degeneration: A 5-year prospective MRI study in asymptomatic individuals. Spine. 2002;27(2):125-134.

https://doi.org/10.1097/00007632-200201150-00002

Kakitsubata Y, Theodorou DJ, Theodorou SJ, Trudell D, Clopton PL, Donich AS, et al. Magnetic Resonance Discography in Cadavers: Tears of the Annulus Fibrosus. Clinical Orthopaedics and Related Research (1976-2007). 2003;407:228-240.

https://doi.org/10.1097/00003086-200302000-00032

de Schepper EI, Damen J, van Meurs JB, Ginai AZ, Popham M, Hofman A, et al. The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine. 2010;35(5):531-536.

https://doi.org/10.1097/BRS.0b013e3181aa5b33

Hoy D, March L, Brooks P, Woolf A, Blyth F, Vos T, et al. Measuring the global burden of low back pain. Best practice & research Clinical rheumatology. 2010;24(2):155-165.

https://doi.org/10.1016/j.berh.2009.11.002

Driscoll T, Jacklyn G, Orchard J, Passmore E, Vos T, Freedman G, et al. The global burden of occupationally related low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases. 2014;73(6):975-981.

https://doi.org/10.1136/annrheumdis-2013-204631

Berry JA, Elia C, Saini HS, Miulli DE. A review of lumbar radiculopathy, diagnosis, and treatment. Cureus. 2019;11(10).

https://doi.org/10.7759/cureus.5934

Van Der Windt DA, Simons E, Riphagen II, Ammendolia C, Verhagen AP, Laslett M, et al. Physical examination for lumbar radiculopathy due to disc herniation in patients with low‐back pain. Cochrane database of systematic reviews. 2010(2).

https://doi.org/10.1002/14651858.CD007431.pub2

Clark R, Weber RP, Kahwati L. Surgical management of lumbar radiculopathy: a systematic review. Journal of general internal medicine. 2020;35(3):855-864.

https://doi.org/10.1007/s11606-019-05476-8

Hirata FH, Guimarães AS, Oliveira JXd, Moreira CR, Ferreira ETT, Cavalcanti MGP. Evaluation of TMJ articular eminence morphology and disc patterns in patients with disc displacement in MRI. Brazilian oral research. 2007;21(3):265-271.

https://doi.org/10.1590/S1806-83242007000300013

Sener S, Akgunlu F. MRI characteristics of anterior disc displacement with and without reduction. Dentomaxillofacial Radiology. 2004;33(4):245-252.

https://doi.org/10.1259/dmfr/17738454

Amin RM, Andrade NS, Neuman BJ. Lumbar disc herniation. Current reviews in musculoskeletal medicine. 2017;10(4):507-516.

https://doi.org/10.1007/s12178-017-9441-4

Okada E, Matsumoto M, Fujiwara H, Toyama Y. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers. European Spine Journal. 2011;20(4):585-591.

https://doi.org/10.1007/s00586-010-1644-y

Xu B-S, Xia Q, Ma X-L, Yang Q, Ji N, Shah S, et al. The usefulness of magnetic resonance imaging for sequestered lumbar disc herniation treated with endoscopic surgery. Journal of X-ray science and technology. 2012;20(3):373-381.

https://doi.org/10.3233/XST-2012-0336

Haig AJ, Tomkins CC. Diagnosis and management of lumbar spinal stenosis. Jama. 2010;303(1):71-72.

https://doi.org/10.1001/jama.2009.1946

Alexander CE, Varacallo M. Lumbosacral radiculopathy. StatPearls [Internet]. 2021.

Madsen R, Jensen TS, Pope M, Sørensen JS, Bendix T. The effect of body position and axial load on spinal canal morphology: an MRI study of central spinal stenosis. Spine. 2008;33(1):61-67.

https://doi.org/10.1097/BRS.0b013e31815e395f

Minamide A, Yoshida M, Maio K. The natural clinical course of lumbar spinal stenosis: a longitudinal cohort study over a minimum of 10 years. Journal of Orthopaedic Science. 2013;18(5):693-698.

https://doi.org/10.1007/s00776-013-0435-9