Prevalence Of Disc Bulge And Associated Abnormalities At Different Levels Of Lumbar Spine MRI In Patients With Low Back Pain

Background: Low back pain (LBP) is one of the top ten causes of visits to hospitals. Literature review shows that 84% of people have low back pain at some stages of their lives. For low back pain best modality for diagnosis is MRI for that we main focus on low back pain in MRI Department.

Objective:  To find out the frequency of disc bulge and other abnormalities at different levels of lumbar spine MRI in patients with low back pain at NWGH Peshawar.

Methods: This was a cross-sectional study conducted in NWGH. The sample size was 250, calculated by RaoSoft Calculator. Confidence interval 95% and 0.05 P value. The study was conducted during April-September 2021. Data were collected from patients coming to the radiology department for lumbar scan MRI and analyzed by SPSS version 21.

Results: There were 250 patients with LBP, out of these, 133 (53.8%) patients were male and the remaining 117 patients were female. The age of participants range from 10 to 89 and was categorized into four groups. Disc bulges (91.6%) were the commonest pathology responsible for LBP. The most affected lumbar vertebral level by disc bulge was LV4/LV5. In 70.8% of patients having nerve root compression, 55.9% patients had bilateral nerve root compression on the on the level of LV4/LV5 which was the commonest site of nerve root compression. Out of over all patients 16.8% patients had thecal sac compression, 0.8% had soft tissue mass, 4.0% had muscle spasm, 14.4% had abnormal lumbar lordosis and 1.6% had abnormal vertebral heights.

Conclusions: This population-based study shows the frequency of disc bulge and other abnormalities at different level causing low back pain in the previous five months in patients at NWGH Peshawar. Males were more affected as compared to females and people with middle ages were at increased risk of experiencing LBP. Disc bulge (91.6%) was the commonest pathology, followed by nerve root compression (70.8%), thecal sac compression (16.8%), soft tissue mass (0.8%), muscle spasm (4.0%), abnormal lumbar lordosis (14.4%) and abnormal vertebral heights (1.6%). Future studies with long-term follow-up for determining the benefits of treatments are warranted.