Evaluation of Degenerative Lumbosacral Diseases and Common Location of Disc Herniations causing Radiculopathy

Introduction: Low back pain is a common cause of morbidity in all individuals. An accurate diagnosis regarding the type and extent of pathology is essential for operative as well as non operative treatment. The most widely used diagnostic modality to asses back pain are X-ray and MRI. X-ray though inaccurate, is cheap and readily available along with the drawback of ionizing radiation and less soft tissue detailing. Aim: This study was under taken to study the various imaging findings in degenerative diseases of lumbosacral spine and common location of disc herniation causing radiculopathy. Materials and Methods: The study was prospective study design. Symptomatic patient referred from various referral hospitals and units, with history of backpain were referred to Department of Radiodiagnosis, Navodaya Medical College. Total 100 patients with backpain who underwent MRI were included in the study from October 2012 to March 2014. Investigation, clinical examination and X-ray were performed and findings compared with MRI. Results: Of the total 100 patients evaluated, most of the spine changes were of degenerative type, of which disc degeneration was major cause of backpain. Lumbar spine was more significant in involvement than thoracic spine in the study group and also among both the genders, females had higher preponderance with correlation of findings, found a higher incidence in 4th decade of life. Conclusion: Most common signs being of degenerative causes of back pain and the most common age group being in the fourth decade of life. The finding in this study was that degenerative discs of the lumbar spine occur most commonly at L4/5 and L5/S1. Diagnostic value of MRI in the study offers a reliable evaluation with high specificity and positive predictive value, in order to make appropriate therapeutic decisions. R ad io lo g y S ec tio n Evaluation of Degenerative Lumbosacral Diseases and Common Location of Disc Herniations causing Radiculopathy MallikaRjun MD, Chetan M, SantoSh Patil InTROduCTIOn In various age groups, backache is major cause of concern. As compared to traditional X-ray investigation, MRI has turned out to be the most important imaging technology in diagnosis of spine pathology to detect disease and its progress along with precise route to operative improvement in the condition of patient. It was found, in a study that both physicians and patients preferred MRI to radiographic evaluations but evaluations at the primary care setting had very little additional benefits to the patients because of increasing cost of care and increasing number of patients kept getting operated for spine disease [1]. The discs receive nutrition by diffusion of fluid from the marrow of the vertebral bodies and via the annulus fibrosus from the blood vessels surrounding it. With ageing may interfere with keywords: Anatomical diagnosis, Backache, Lumbar spine disc nutrition and further the degenerative process while changes inside the cartilaginous endplate and the vertebral body [2]. It is clear that MRI can detect a great amount of lumbosacral disease, but its significance of clinically remains unknown [3]. In the initial assessment of patients with acute on set low backpain, the plain film radiography is hardly ever useful. Two large retrospective studies have been demonstrated that, the low yield of lumbar spine radiographs [4,5]. In patients with worsening neurologic deficits or a suspected systemic cause of backpain such as infection or neoplasm, then MRI or CT studies should be considered. While referred for surgery, these imaging studies may also be suitable [6-8]. By MRI, the difference between the nucleus pulposus and the inner annulus fibrosus is not possible. Regular disks generally do not expand past the margins of the adjacent vertebral our www.ijars.net Mallikarjun MD et al., Evaluation of Degenerative Lumbosacral Diseases International Journal of Anatomy, Radiology and Surgery. 2017 Jul, Vol-6(3): RO22-RO27 23 bodies. However, diffuse extension beyond the margins by way of 1 to 2 mm may additionally occur in a few histologically regular disks [9]. MR is very sensitive for detecting sequestered disc fragments [10]. Because of variety of environmental factors, life style, genetic and also of normal aging process, degeneration of inter vertebral disc may becomes complex and begins early in life. Mild degree of degenerative changes may consider as physiological and should be considered pathologic only if these abnormalities are causing clinical signs and symptoms. For LBP of degenerative cause including the vertebral periosteum, facet joints, ligaments and disc, different structures of the spine are accountable. The most common location of these changes is lumbar spine. osseous changes related to disc degeneration vertebral bodies [11]