THE DIAGNOSTIC ROLE OF LUMBOSACRAL SPINE MAGNETIC RESONANCE IMAGING IN PATIENTS PRESENTING WITH LOW BACK PAIN

Abstract

Background: Low back pain (LBP) is a prevalent musculoskeletal disorder, affecting nearly 20% of the global population and contributing significantly to disability and reduced quality of life. Magnetic resonance imaging (MRI) plays a crucial role in diagnosing lumbar spine pathologies due to its ability to detect soft tissue abnormalities, degenerative changes, and nerve involvement. Early identification through MRI can help in better clinical decision-making and effective management of LBP.

Objective: This study aimed to assess the diagnostic significance of lumbosacral spine MRI in patients presenting with low back pain, focusing on degenerative disc conditions and related structural abnormalities.

Methods: A total of 389 patients with clinically diagnosed LBP underwent lumbar spine MRI. Patients with traumatic back injuries were excluded. Imaging protocols included T1-weighted imaging with contrast and gradient echo (GRE) sequences for suspected neoplastic or inflammatory conditions. MRI images were analyzed using a picture archiving and communication system (PACS). Radiological reports were generated by the principal investigator under the supervision of two experienced neuroradiologists. Statistical analyses included Pearson’s chi-square test and multivariate correlation, applied to both adjusted and unadjusted models to determine associations and significance (p < 0.05).

Results: Among 389 participants, 215 (55.2%) reported moderate LBP severity, predominantly linked to informal occupations and physical stress activities such as weightlifting. Radiating pain was observed in 292 patients (75.0%), with higher prevalence in individuals aged ≥49 years (42.7%). The most commonly affected spinal segment was L4-L5, identified in 306 cases (78.6%). High-intensity zones (HIZ) and disc desiccation were more prevalent in older adults. Annular tears were found in 184 patients (47.3%), particularly among those with severe pain intensity and burning sensations.

Conclusion: The diagnostic utility of MRI is significant in identifying degenerative changes in patients aged 40 years and above, particularly involving the L4-S1 intervertebral discs. Key pathological findings included disc herniation, annular tears, disc desiccation, and high-intensity zones. A strong association was noted between physical stress, occupational factors, and severity of LBP, with burning sensations often correlating with disc bulges and annular tears.