Pattern of lumbosacral MRI findings among adults with chronic low back pain and lumbar canal stenosis at a Neuro-surgical Hospital in South-East Nigeria

Abstract

Background: Lumbar canal stenosis often associated with chronic low back pain describes abnormal narrowing of the lumbar spinal canal, likely resulting in compression of neural elements within the spinal canal and the lateral recesses. This study seeks to determine the proportion of cases of lumbar canal stenosis among adult patients presenting with chronic low back pain and the pattern of findings seen on MRI of the lumbosacral spine at Memfys hospital for Neurosurgery, Enugu. Methods: Retrospective study of MRI images for 300 adult patients of both sexes presenting with chronic low back pain between January 1st and December 31st 2013. Statistical analysis done using Statistical Package for the Social Sciences IBM – SPSS for windows version 21.0 (2012). Results: Out of 300 patients with chronic low back pain, 134 (44.7%) showed MRI features of canal stenosis. Mean and median ages were 57.3 and 58.0 years respectively. There were more females (57.5%) than males (42.5%). Commonest and least affected sites were L4/5 and T12/l1 respectively. Pattern of lumbosacral MRI findings was as follows, postero-lateral disc herniation (92.5%), ligamentumflavum hypertrophy (53.7%), kyphosis (26.1%), facet hypertrophy (25.4%), retrolisthesis (18.7%), vertebral degenerative changes (17.9%), vertebral fracture (11.9%), spinal mass (9.7%), vertebral mass (9.0%) and scoliosis (7.5%). Conclusion: More than two in five adult patients presenting with chronic low back pain may also have lumbar canal stenosis. MRI of the lumbosacral spine shows various osseous and soft tissue anomalies among this group of patients.

Keywords

• chronic low back pain
• mri
• canal stenosis