Correlation between Patterns of Magnetic Resonance Imaging Findings and Clinical Features in Patients with Low Back Pain due to Lumbar Degenerative Disc Disease, Attending Orthopedics and Neurology Outpatient Clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2021.
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Date
2021-09
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Addis Abeba University
Abstract
Background: Low back pain(LBP) is defined as pain coming from between the lower rib
margins and the gluteal folds. It is usually accompanied by pain and neurological symptoms in
the lower limbs. Lumbar degenerative disc disease constitutes a group of degenerative pathologic
changes that are almost universal with increasing age and are a common cause of mechanical
low back pain. There were contradictory reports regarding the correlation of MRI(magnetic
resonance imaging) findings with clinical presentations.
Objective: To evaluate the correlation between patterns of MRI findings and clinical features in
patients with low back pain due to lumbar degenerative disc disease(LDDD) at Ortho-spine
unite, in Tikur Anbessa Specialized Hospital(TASH), Addis Ababa, Ethiopia, from April 1,
2020, to March 30, 2021.
Method: Hospital-based retrospective cross-sectional study was conducted in TASH, with a
randomly selected sample of 246 patients from April 1, 2020, to March 30, 2021. Data was
collected using Kobo Toolbox version 1.27.3 and exported to SPSS Windows 25 for analysis.
Chi-square test, Bivariable, and Multivariable binary logistic regression analysis were applied to
evaluate the association of different variables.
Result: Of the total patients, 56.5% had radiculopathy, 6.1% had extremity weakness and 4.5%
had bowel and bladder incontinence. Disc herniation was present in 82.9%, disc degeneration in
54.1%, neural foraminal stenosis in 56.6% and spinal canal stenosis in 44.3%. Spinal canal
stenosis was significantly associated with age (age 40-59 [AOR=2.19, 95% CI (1.119-4.287)] &
age >60 [AOR=3.7, 95% CI (1.753-7.691)] and radiculopathy, [AOR=2.4, CI (1.388-4.072)].
Neural foraminal stenosis was significantly associated with age [age >60, AOR=3.425, 95% CI
(1.560-7.519)], radiculopathy [AOR=2.7, 96%, CI (1.554-4.738)]. Neural foraminal stenosis was
also significantly associated with the SLR(straight leg raise) test [AOR=2.0, 95% CI (1.0264.083)].
Conclusion:
There is an association between MRI findings and the clinical presentation of
patients. Spinal canal stenosis and neural foraminal stenosis were associated with radiculopathy
and older age. The lower lumbar levels are highly affected by DDD due to the higher mechanical
stress at this level. Radiculopathy is the most frequent clinical presentation accompanying LBP,
and Disc herniation was the commonest degenerative finding.
Description
Keywords
LBP, MRI, LDDD, radiculopathy, disc degeneration, disc herniation, spinal canal stenosis, neural foraminal stenosis.