Clinical correlation of magnetic resonance imaging with symptom complex in prolapsed intervertebral disc disease: A cross-sectional double blind analysis

Abstract

Introduction:Low backache (LBA) is one of the most common problems and herniated lumbar disc is one of the most commonly diagnosed abnormalities associated with LBA. Disc herniation of the same size may be asymptomatic in one patient and can lead to severe nerve root compromise in another patient.Objective:To evaluate correlation between the clinical features of disc collapse and magnetic resonance imaging (MRI) finding to determine the clinical importance of anatomical abnormalities identified by MRI technique.Summary:From January 2010 to January 2012, 75 otherwise healthy patients (43 males 32 females) between the age of 19 and 55 years (average age was 44.5 years) with low back pain and predominant complaint of root pain who presented to our clinic were included in the study.Materials and Methods:Proper screening was done to rule out previous spine affection and subjected to MRI.Results:The results were analyzed under four headings viz. disc herniation, disc degeneration, thecal sac deformation and neural foramen effacement. All patients had a visual analog score (VAS) score more than 6. The interrater correlation coefficient kappa was calculated to be k=0.51. There were total 44 patients with herniation, 25 patients had mild, one patient had moderate degree of thecal sac deformation, 21 patients had one or more levels of foraminal effacement by the herniated tissue, 100% of the patients had disc degeneration ranging from grade 1 to 3 at different levels; and 48 patients (64%) had radiculopathy, six (8%) patients had bilateral and others had ipsilateral affection.Conclusion:In our study, the correlation was made between clinical findings and MRI findings. It can safely be concluded that treating physician should put more emphasis on history, clinical examination, and make the inference by these and then should correlate the clinical findings with that of MRI to reach a final diagnosis.

Reliability of Magnetic Resonance Imaging Findings Interpretation in Patients with Lumbar Disk Herniation

“…In a few studies, the extent of agreement between the examiners was moderate (κ=0.51) and in test timings, it was excellent (κ=0.88) for the first examiner but good for the second examiner [11]. Similar to the present study, was the findings of Raininko and associates [15].…”

“…One basic reason for the low agreement on the extent of "lumbar disk bulge" was due to not specifying the process of disk bulging by radiologist in 42% of cases. But in the present study (κ=0.75), both examiners assessed all the morphologic aspects of disk very carefully on the basis of defined criteria [11,12,15].…”

“…MRI was performed Axially (across the lumbar disks and superior and inferior end plates of vertebrae) and sagittally. Before assessing the disk diseases, MRI scans were first looked up to rule out any inflammation, infection, neoplasm, metabolic diseases; spinal stenosis and previous surgery [11].…”

The Effect of Fusion Added to Lumbar Discectomy in Patients with Modic Changes: A Retrospective Comparative Outcome Analysis Regarding Back Pain Control

“…1,2,3,15,19 More than 88% of patients included in the current study were operated upon for pathologies affecting L 4-5 and L5-S1 levels (38.6% for L4-5 level and 50% for L5-S1 level) and this was similar to other reports. 1,19,20,21 In the current study, both patients' groups (the discectomy and fusion groups) showed statistically significant clinical and functional improvements in terms of changes in the mean pre-operative and post-operative VAS for low back pain and ODI values. However, comparison between both groups failed to reveal that any of them was significantly superior to the other regarding the forementioned parameters.…”

The Relationship Between History and Physical Examination Findings and the Outcome of Electrodiagnostic Testing in Patients With Sciatica Referred to Physical Therapy

“…7,9,12,25,26,38 The majority of LBP is considered nonspecific, having no clear pathoanatomic cause 1,3 ; however, one specific cause of LBP is lumbosacral radiculopathy. 6,33 Known commonly as sciatica or lumbar radiculopathy, this condition has some unique defining characteristics. 24,34 Most commonly the result of a herniated disc, patients with sciatica typically complain of LBP and radiating lower extremity symptoms, which are often described as sharp, piercing, throbbing, aching, or burning, along with dermatomal paresthesia.…”