JBM  Vol.6 No.4 , April 2018
Pattern of MRI Findings in Patients with Low Back Pain at National Orthopaedic Hospital, Enugu Nigeria
Abstract: BACKGROUND: Low back pain is a major cause of referral to the Spine clinic. In the adult population 50% - 90% may present with low back pain at least once in their life time. Currently, the gold standard for diagnosing the etiology of low back pain is MRI. The protocol at NOHE is to request MRI for patients whose clinical patterns are indicative for invasive intervention. OBJECTIVE: To determine the pattern of MRI findings in patients with low back pain attending spine clinic at NOHE. METHODS: This is a retrospective study of 60 MRI of adult patients with low back pain with clinical need for invasive intervention. The scan was carried out with A Basda BTI 0.35T MRI System using the standard protocol, with sagital and axial T1 and T2-weighted and STIR. Images were from Onis 2.5 digital co. limited. RESULT: Thirty five (58.3%) were males while 25 (41.7%) were females with majority aged between 40 - 59 years. About 90% of the images had disc prolapse while 73% had disc height reduction. The commonest cause of spinal canal stenosis was disc prolapse, thickened ligamentum flavum, spondylolisthesis and osteophytes. Six (10%) of the patient did not have any lesion on MRI. L4/5 was the commonest affected segment while 90% of abnormal cases had multilevel involvement. CONCLUSION: There is high yield of diagnosis with MRI scan among low back pain patients with clinical need for invasive intervention, hence an excellent navigating tool. L4/L5 disc level remains the commonest culprit.
Cite this paper: Iyidobi, E. , Obande, B. and Ekwunife, R. (2018) Pattern of MRI Findings in Patients with Low Back Pain at National Orthopaedic Hospital, Enugu Nigeria. Journal of Biosciences and Medicines, 6, 85-94. doi: 10.4236/jbm.2018.64007.

[1]   Ramdan, N.S.A., Hashim, A.Y.B., Kamat, S.R., Mokhtar, M.N.A. and Asmai, S.A. (2014) On Lower-Back Pain and Its Consequence to Productivity. Journal of Industrial and Intelligent Information, 2, 83-87.

[2]   Hanley, E.N. and David, S.M. (1999) Current Concepts Review—Lumbar Arthrodesis for the Treatment of Back Pain. The Journal of Bone and Joint Surgery, 81, 716-730.

[3]   Uduma, U., Ongolo, P., Assam, G., Fokam, P. and Motah, M. (2011) Evaluation of Pattern of Magnetic Resonance Images of Lumbo—Sacral Spine in Cameroon—A Pioneer Study. Global Journal of Medical Research, 11, 30-41.

[4]   Irurhe, N.K., Adekola, O.O., Quadri, A.R., Menkiti, I.D., Udenze, I.C. and Awolola, N.A. (2012) The Magnetic Resonance Imaging Scan Findings in Adult Nigerians with Low Back Pain. World Journal of Medical Sciences, 7, 204-209.

[5]   Orege, J.A., Abuya, J.M. and Onditi Elias, G.D. (2013) Common Magnetic Resonance Imaging (MRI) Patterns in Patients with Low Back Pain in Eldoret, Kenya. Journal of Scientific & Innovative Research, 2, 260-279.

[6]   Ebubedike, U.R., Umeh, E.O., Ogbole, G.I., Ndubuisi, C.A., Mezue, W.C. and Ohaegbulam, S.C. (2017) Low Back Pain in Adults: Pattern of Abnormal Findings on MRI Lumbosacral Spine Images in South-East Nigeria. Orient Journal of Medicine, 29, 85-90.

[7]   Sangani, S.G., Joshi, M.M., Sangani, C.S. and Dave, K.A. (2014) Correlation of Magnetic Resonance Imaging Findings in Low Back Pain Patients with Daily Travel Time and Mode. International Journal of Advances in Medicine, 1, 206-212.

[8]   Surendra, K.W. and Neha, D. (2014) Correlation of Pain and Disability with MRI Findings in Patients with Lumbar Discogenic Back Pain. International Journal of Physiotherapy and Research, 2, 418-423.

[9]   Saeidiborojen, I.R.H., Shobeiri, E. and Saeidiborojeni, S. (2012) Magnetic Resonance Imaging Findings in Low Back Pain and Lower Extremity Radicular Chronic Pain. Journal of Injury and Violence Research, 4, 37.

[10]   Omoke, N.I. and Amaraegbulam, P.I. (2016) Low Back Pain as Seen in Orthopedic Clinics of a Nigerian Teaching Hospital. Nigerian Journal of Clinical Practice, 19, 212-217.

[11]   Modic, M.T., Obuchowski, N.A., Ross, J.S., Brant-Zawadzki, M.N., Grooff, P.N., Mazanec, D.J. and Benzel, E.C. (2005) Acute Low Back Pain and Radiculopathy: MR Imaging Findings and Their Prognostic Role and Effect on Outcome. Radiology, 237, 597-604.

[12]   Galukande, M., Muwazi, S. and Mugisa, D.B. (2005) Aetiology of Low Back Pain in Mulago Hospital, Uganda. African Health Sciences, 5, 164-167.

[13]   This Day Live (2017) Tackling Low Life Expectancy in Nigeria, 2016.

[14]   Park, D.K., AN, H.S., Lurie, J.D., et al. (2010) Does Multilevel Lumbar Stenosis Lead to Poorer Outcomes? A Subanalysis of the SPORT Lumbar Stenosis Study. Spine, 35, 439-446.

[15]   Atlas, S.J. and Deyo, R.A. (2001) Evaluating and Managing Acute Low Back Pain in the Primary Care Setting. Journal of General Internal Medicine, 16, 120-131.

[16]   Jarvik, J.J., Hollingworth, W., Heagerty, P., Haynor, D.R. and Deyo, R.A. (2001) The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: Baseline Data. Spine, 26, 1158-1166.

[17]   Kim, S.-Y., Lee, I.-S., Kim, B.-R., et al. (2012) Magnetic Resonance Findings of Acute Severe Lower Back Pain. Annals of Rehabilitation Medicine, 36, 47-54.

[18]   O’Donnell, O. (2007) Access to Health Care in Developing Countries: Breaking down Demand Side Barriers. Cadernos de Saúde Pública, 23, 2820-2834.

[19]   Jacob, M. (2011) Pattern of Spine Degenerative Disease among Patients Referred for Lumbar Magnetic Resonance Imaging at Muhimbili National Hospital, Dar es Salaam, Tanzania March-September-2010. Dissertation, Muhimbili University of Health and Allied Sciences, Muhimbili, Tanzania.

[20]   Marek, S. and Robert, G. (2003) Lumbar Spinal Stenosis in the Elderly: An Overview. European Spine Journal, 12, 170-175.

[21]   Sasaki, K. (1995) Magnetic Resonance Imaging Findings of the Lumbar Root Pathway in Patients over 50 Years Old. European Spine Journal, 4, 71-76.

[22]   Wong, H.K. and Bose, K. (1992) Spinal Stenosis: Results of Surgical Treatment. Journal of the Western Pacific Orthopaedic Association, 29, 37-41.

[23]   Wu, H., Yu, W.-D., Jiang, R. and Gao, Z.-L. (2013) Treatment of Multilevel Degenerative Lumbar Spinal Stenosis with Spondylolisthesis Using a Combination of Microendoscopic Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion. Experimental and Therapeutic Medicine, 5, 567-571.

[24]   Jensen, M.C., Brant-Zawadzki, M.N., Obuchowski, N., et al. (1994) Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain. The New England Journal of Medicine, 331, 69-73.

[25]   Jani, T., Jaro, K., Jaakko, N., Simo, T., Simo, N., Marjo-Riitta, J., Eero, K. and Osmo, T. (2009) Prevalence of Degenerative Imaging Findings in Lumbar Magnetic Resonance Imaging among Young Adults. Spine, 34, 1716-1721.

[26]   Hay, O., Dar, G., Abbas, J., Stein, D., May, H., Masharawi, Y., et al. (2015) The Lumbar Lordosis in Males and Females, Revisited. PLoS ONE, 10, e0133685.