Evaluation of Degenerative Changes in the Lumbosacral Spine Using MRI: A Prospective Observational Study

Abstract

Background: Degenerative disorders of the lumbosacral spine are considered one of the most frequent causes of chronic back pain and disability worldwide. Magnetic
Resonance Imaging (MRI) is considered of tremendous value for the early detection of degenerative disorders of the lumbosacral spine.
Objectives: To evaluate degenerative changes of the lumbosacral spine using MRI and to analyze their distribution with respect to age, gender, spinal level, and clinical
presentation.
Materials and Methods: This study was a case series of patients who presented with low back pain and who had an MRI done on their lumbosacral region. The
information obtained during this study was related to the presence of disc degeneration, disc bulge or herniation, facet arthropathy, hypertrophy of the ligamentum
flavum, spinal canal stenosis, and nerve root compression. Disc degeneration was graded according to the Pfirrmann grading system.
Results: The most commonly affected levels for degenerative changes were L4-5 and L5-S1. Intervertebral disc degeneration was most frequent, followed by disc
bulge, facet arthropathy, and ligamentum flavum thickening. With increasing age, there was also an increase in the severity of disc degeneration. Though significant
degenerative changes were observed with MRI, there was a variable relationship between clinical symptoms and imaging findings.
Conclusion: MRI is an essential investigation in the evaluation of degenerative changes in the lumbar spine. Degenerative changes in the lumbar spine increase with
age. They usually involve the lower spinal segments. However, MRI findings must always be correlated with clinical findings in order to avoid overdiagnosis and
unnecessary treatment.