A comparative study to evaluate disc degeneration on magnetic resonance imaging in patients with chronic low back pain and asymptomatic individuals

Singh, Roop; Kumar, Pradeep; Wadhwani, Jitendra; Yadav, Rohtas K; Khanna, Mohit; Kaur, Svareen

doi:10.1177/22104917211039522

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…9 One more research demonstrated that main MRI imaging features of disc herniation are usually at L4-L5 and L5-S1 levels in both genders. 13 These imaging features are in line with one more study which also showed the evidence that the spinal canal was smallest in both men and women at the level of L5-S1 and widest at L1-L2. 14 Our study shows the average age 45 years (mean age 44.64 years) in patients with complaints of low back ache.…”

Section: Resultssupporting

confidence: 88%

Magnetic Resonance Imaging of Lumbar Spine in Lower Backache: A Comparative Study on Gender Basis

Azeem¹,

Anwar²,

Kadri³

2022

J. Bahria Uni. Med. Dent. Coll.

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Objective: To compare the clinical features of lower backache with Magnetic Resonance Imaging (MRI) findings on gender basis. Study design & Setting: A cross-sectional descriptive study was carried out among male & female patients with a backache at Sir Syed Hospital, Karachi. This study conducted from 1st Jan 2020 to 1st June 2020. We studied 90 patients by using the non-probability convenient sampling technique. Methodology: Lower backache is a common problem that creates disability. MRI lumbar spine without contrast were reviewed with clinical complaints. Performa was used after the ethical approval from Institutional Research and Ethical committee. Components focused during the study in MRI findings at different spinal levels were disc bulging, neural foraminal compromise, nerve root compression, ligamentum flavum and facet joint hypertrophy. Results: The results showed that the mean age of 90 patients was 44.64 years. On MRI imaging 46(86.8%) males and 26(70.3%) females had disc desiccation but multi-level disc osteophyte complexes were demonstrated more in females 11(29.7%). Diffuse disc bulge is more in males at L4-5 and L5-S1 level 49(92.5%) than in females 34(91.9%) at L4-5 and 33(89.2%) at L5-S1 level with mild to moderate spinal canal stenosis. The narrowing of Neural foramen is almost similar at L4-5 level in both gender but more at L5-S1 in females 35(94.6%) as compared to males 49(92.5%) with nerve root compression. Overall male patients tended to have slightly more disc degenerative changes than females. Conclusion: Lower Lumbar disc disease is a common problem showing significant disc space narrowing and bulges slightly more in our male population than females.

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Section: Resultssupporting

confidence: 88%

Magnetic Resonance Imaging of Lumbar Spine in Lower Backache: A Comparative Study on Gender Basis

Azeem¹,

Anwar²,

Kadri³

2022

J. Bahria Uni. Med. Dent. Coll.

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“…The most common site of degenerative changes of lumbosacral spine was L4-5 followed by L5-S1 level, and the least was L2-3 in accordance with other studies [17,26,[28][29][30][31]. As regards the disc morphology, the commonest type was disc protrusion (48%), 32.5% showed disc bulge, and 6.5% had disc extrusion and sequestration, and this agreed with Ravikanth et al [17]; they found that the commonest type was disc protrusion (69.4%).…”

Section: Discussionsupporting

confidence: 90%

Evaluation of health related quality of life with the use of Oswestry disability index in degenerative discogenic low back pain

El-Hady¹,

Molla

Elwan³

et al. 2023

Egypt Rheumatol Rehabil

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Background Intervertebral disc degeneration (IVD) is a main underlying cause for low back pain (LBP). Oswestry Disability Index (ODI) is a valuable tool used to measure patient’s low back functional outcome. Our aim is to evaluate the relation between clinical assessment of LBP and health related quality of life with the use of ODI and magnetic resonance image (MRI) findings in patients with degenerative prolapsed IVD disease. Result There was a significant correlation between Pfirrmann grades and ODI (p < 0.0001) and with type of disc morphology mostly protrusion (p < 0.0001) but insignificant correlation with visual analogue scale (VAS) (p = 0.198) and most of the clinical parameters (p > 0.05). There was a significant correlation between ODI and VAS (p = 0.003). Higher Pfirrmann grades were found at lower lumbosacral levels L4-5 and L5-S1. Conclusion Higher Pfirrmann grades correlated with the increased ODI. No association was found between MRI grading in lumbosacral spine with pain intensity and most of the clinical parameters among persons with discogenic LBP. Chronic LBP is widely accepted to be a multifactorial disorder that could not be contained within a single lumbar compartment. Clinician should not depend on MRI findings only in the diagnosis. History from the patient and clinical examination is particularly important to reach the final diagnosis. ODI might be convenient in achieving patient’s confidence and decreasing unnecessary investigations.

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“…26 We concur with the literature that pain does not necessarily associated with degenerative discs. 14,26 However, it is possible that LBP is predisposed to the specific degeneration patterns and intensity linked to abnormal orientation. We are of the opinion that the orientation of the disc in the vertebral column plays a crucial role in transmission biomechanical forces and any alteration in it may predispose to back pain.…”

Section: Discussionsupporting

confidence: 89%

“…[23][24][25] The significant normal variation in the sagittal alignment of the spine between asymptomatic people and back pain sufferers has also been noted in earlier research. 16,23,24,26 According to Singh et al, a disc's abnormal orientation may render it more susceptible to degeneration. 26 We concur with the literature that pain does not necessarily associated with degenerative discs.…”

Section: Discussionmentioning

confidence: 99%

“…16,23,24,26 According to Singh et al, a disc's abnormal orientation may render it more susceptible to degeneration. 26 We concur with the literature that pain does not necessarily associated with degenerative discs. 14,26 However, it is possible that LBP is predisposed to the specific degeneration patterns and intensity linked to abnormal orientation.…”

Section: Discussionmentioning

confidence: 99%

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Do lumbar intervertebral disc parameters in patients with chronic low back pain differ quantitatively from healthy individuals? A comparative study

Singh

Kumar

Wadhwani

et al. 2023

Journal of Orthopaedics, Trauma and Rehabilitation

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Objectives: Studies in the past were not able to find any definitive correlation between disc parameters and LBP. The objectives of the current study were to evaluate the association of the lumbar disc parameters with LBP and to find the quantitative differences between the discs in LBP patients and healthy individuals. Methodology: Fifty patients with chronic LBP (group A) and 25 healthy individuals (group B) were subjected to magnetic resonance imaging of lumbar spine. Disc parameters of orientation and size were estimated. Results: There was a statistically significant difference in disc angle at L1-L2 ( p = 0.01), L2-L3 ( p = 0.05), and L3-L4 ( p = 0.001), and skin angle at L2-L3 ( p = 0.03) and L4-L5 ( p = 0.05) level. Length and cross-sectional area (CSA) of anterior intervertebral height, posterior intervertebral height, intervertebral disc, anterior disc material, posterior disc material; and volume of anterior disc material and volume of posterior disc material were statistically significantly more at various disc levels in group A. Antero-posterior dural sac length and CSA of the sac were statistically significantly smaller at L4-L5 and L5-S1 levels. There was a significant association between average disc height and dural sac area at L1-L2 ( p-value = 0.0393) and L5-S1 ( p-value = 0.0022) and CSA of the disc and dural sac area at L5-S1 ( p-value = 0.049) in group A. Conclusions: There was a significant difference in the lumbar disc orientation and dimensions between LBP patients and healthy individuals. Larger disc parameters (height, volume, CSA, and length) and altered orientation may affect the biomechanics of the spine, thus predisposing to LBP.

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A comparative study to evaluate disc degeneration on magnetic resonance imaging in patients with chronic low back pain and asymptomatic individuals

Cited by 4 publications

References 26 publications

Magnetic Resonance Imaging of Lumbar Spine in Lower Backache: A Comparative Study on Gender Basis

Magnetic Resonance Imaging of Lumbar Spine in Lower Backache: A Comparative Study on Gender Basis

Evaluation of health related quality of life with the use of Oswestry disability index in degenerative discogenic low back pain

Do lumbar intervertebral disc parameters in patients with chronic low back pain differ quantitatively from healthy individuals? A comparative study

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