Title: Magnetic Resonance Imaging of Degenerative Disease of the Lumbar Spine

Authors: Dr Shyamala Javvadi, Dr Kiranmayi Chalasani, Dr Julius N Toppo, Dr Priyanka

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.54

Abstract

Introduction: In Low backache patients of 35 to 50 yrs age group, degenerative disc disease was found to be the most common culprit. The superior soft-tissue contrast resolution of MRI has allowed for noninvasive detailed anatomic evaluation of the spine without radia­tion exposure and is considered the imaging modality of choice for detection of an actual cause of radicular symptoms versus regular age-related changes. The most commonly affected region is the lumbar spine in acquired degenerative disease.

Purpose: Role of MRI in the evaluation of the degenerative disc changes in the lumbosacral spine in patients with low backache.

Materials and Methods: An observational cross-sectional study of degenerative changes of the lumbosacral spine in patients with low backache referred to the department of Radio-diagnosis, KIMS, Amalapuram, A.P. 

Machine: Philips Achieva, 1.5 Tesla MRI machine.       

Duration:- For period of two months (1st July2019- 31 August 2019).

Sample size- 186.

Results: Out of a total of 186 patients, the incidence of degenerative disc changes is more in females ( 107) compared to males ( 79) with a ratio of 1.35:1. Most of the patients showed osteophytes, schmorl’s nodes, loss of lumbar lordosis, ligamentum flavum hypertrophy, facet joint arthrosis, endplate (modic) changes. Disc bulges and herniations were the disc contour abnormalities found in patients with degenerative disc disease. The most common site for bulges and herniations was the L4-L5 intervertebral disc level.

Conclusion:  MRI is the modality of choice for imaging of degenerative disease of the lumbar spine.   

Keywords: MRI, lumbar spine, intervertebral disc,disc degenerative changes. 

References

  1. Maus TP: Imaging of spinal stenosis: Neurogenic intermittent claudication and cervical spondylotic myelopathy. Radiol Clin North Am 50(4):651–679, 2012.
  2. Jacobs DS: Degenerative diseases of the spine. Haaga: CT and MRI of the Whole Body, ed 5, St. Louis, 2008, Mosby, pp 755–799.
  3. Hammouri QM, Haims AH, et al: The utility of dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine. Spine (Phila Pa 1976) 32(21):2361–2364, 2007.
  4. Khalil JG, Nassr A, Maus TP: Physiologic imaging of the spine. Radiol Clin North Am 50(4):599–611, 2012.
  5. Van Rijn JC, Klemetso N, Reitsma JB, et al: Observer variation in the evaluation of lumbar herniated discs and root compression: Spiral CT compared with MRI. Br J Radiol79:372–377, 2006.
  6. Carrino JA, Morrison WB: Imaging of lumbar degenerative disc disease. Semin Spine Surg 15(4):361–383, 2003.
  7. Suthar P, Patel R, Mehta C, Patel N. MRI evaluation of lumbar disc degenerative disease. Journal of clinical and diagnostic research: JCDR. 2015 Apr;9(4): TC04.Verma SR, Gupta PK, Munshi A, Goyal P, Verma SC, Sardana V.
  8. A Retrospective Analysis Of Magnetic Resonance Imaging Findings In 20-40 Year Old Patients With Low Back Pain. Experience At A Semi Urban Tertiary Healthcare Centre In Northern India. The Internet Journal of Spine Surgery. 2011;6(4):1937-8270.
  9. Yong PY, Alias NN, Shuaib IL. Correlation of clinical presentation, radiography, and magnetic resonance imaging for low back pain-A preliminary survey. JOURNAL-HONG KONG COLLEGE OF RADIOLOGISTS. 2003;6:144-51.
  10. Osman NM, Fawzy FM, Lateef HM. MRI Evaluation of Lumbar Disc Degenerative Disease. Egyptian Journal of Hospital Medicine. 2017 Jul 30;68(2).

Corresponding Author

Dr Shyamala Javvadi

Third Year Post Graduate, Department of Radiodiagnosis, Konaseema Institute of Medical Sciences and Research Foundation