“Correlation of Magnetic Resonance Patterns of Lumbar Disc Disease with Clinical Symptomatology of Patients”

Abstract

Objective:  To describe the patterns of degenerative changes in lumbar spine discs in correlation with cli-nical symptomatology of patients.

Patients and Methods:  This cross sectional analy-tical study was carried out in Radiology Department of Children Hospital Lahore, from October 2006 to Octo-ber 2007. The study included 170 patients who presen-ted with low back and leg pain. All patients underwent lumbar MRI using 1.5 T - scanner. MRI scans were evaluated for magnitude and location of nerve com-pression, disc bulge or disc herniation and the nature of nerve and thecal sac deformation and association of these findings with age, sex and clinical symptomato-logy of patients was evaluated.

Results:  The study included 170 patients, the age range was 20 to 79 years (mean 47 years). Disc bulge was most frequent finding seen in 128 patients (74%), disc herniation was seen in 42 patients (25%) and was common in patient with acute history of backache, while disc bulge was common in patients with chronic symptoms. Overall 131 patients (76%) had MRI evi-dence of nerve or thecal sac compression. There was no significant association between segmental distribu-tion of symptoms and presence of anatomic impair-ment. However, severe nerve compression and disc herniation were significantly associated with pain dis-tal to the knees.

Conclusion:  The presence of disc herniation or ipsi-lateral severe nerve compression at one or multiple sites is strongly associated with distal leg pain and sen-sory symptoms in that leg. Mild to moderate nerve compression, disc degeneration or bulging, and non disc degenerative changes are not significantly associ-ated with specific pain patterns.