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Category: Volume 08 Issue 03 March 2020
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Title: Plain Film Radiography and Magnetic Resonance Imaging in Degenerative Disease of Spine: A Comparative Study

Authors: Naresh Chandra Yadav, Ashok Kumar Verma, Rakesh Kumar Verma, Rashmi

 DOI: https://dx.doi.org/10.18535/jmscr/v8i3.34

Abstract

   

Degenerative disease of spine is a definition that includes a wide spectrum of degenerative abnormalities. Degeneration involves bony structure, ligaments, facet joints and intervertebral disc. During life the spine undergoes continuous changes as a response to physiologic axial load, these age related changes are similar to pathologic degenerative changes and are common asymptomatic finding in adults and elderly persons. Imaging allows complete evaluation of static and dynamic factors related to degenerative disease of spine and is useful in diagnosing the different aspects of spine degeneration. The present cross sectional study is intended to compare and correlate the finding of plain film radiography with that of MRI in degenerative diseases of spine to enable early diagnosis. A total of 60 patients complained of back pain and/or patients with neurologic complaints such as tingling sensations, numbness weakness referred pain in limbs were included in the study. The current study found that percentage of the male patients was 58.33% and of female was 41.7% showing a slight male preponderance for degenerative spine disease. The mean age of incidence in our study was 43.65 years. The youngest and the oldest patients were 24 years and 79 years respectively. The most of the patients were in 40-50 years age group (25%). Lower back pain was the most common feature (70%) followed by radiating pain (55%), followed by tingling and numbness (26.6%) and cervical pain (25%). 13 patients out of 30 (43%) patients above 50 years of age had generalized involvement on plain film as compared to 24 out of 30 (80%) patients on MRI. On plain film, osteophytes were seen in 66% patients and on MRI in 55% patients. Lumbar spine was the commonest region of involvement on both imaging followed by cervical region. Commonest level of spinal canal stenosis was L4/L5 on both plain film and MRI seen in 15 and 24 patients respectively. Plain film showed facet joint arthrosis in 45% patients and on MRI it was seen in 63% patients with commonest level being L4/L5 on both the imaging techniques. Prevalence of neural foraminal obliteration and spinal canal stenosis were significantly higher on MRI as compared to plain film. Plain film is the basic modality which can be used as a baseline imaging. In a symptomatic patient who has failed non operative conservative treatment and has normal X-ray findings, an MRI can be a very useful tool for further evaluation.

Keywords: Spine, Disc bulge, Degenerative disease, Facet joint, Intervertebral disc, Canal stenosis, MRI.

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Corresponding Author

Dr Ashok Kumar Verma

Assistant Professor, Department of Radiodiagnosis, G.S.V.M Medical College, Kanpur, Uttar Pradesh