Magnetic Resonance Imaging Patterns of Lumbosacral Degenerative Changes in Adults with Chronic Low Back Pain in North-Eastern Nigeria

Background: Low back pain (LBP) is one of the most common conditions encountered in clinical practice. There are many possible etiologies with degenerative disease being common among patients with chronic LBP. It is a major cause of disability, morbidity, and high health care cost. Magnetic resonance imaging (MRI) has been shown to be the best modality in detecting most of the causes of LBP and also in follow-up of the patient due to its advantage of excellent soft-tissue resolution and absence of harmful radiation effect associated with some other modalities. This study was aimed at investigating the MRI patterns of lumbosacral degenerative changes in adults with chronic LBP at Federal Teaching Hospital Gombe, North-Eastern Nigeria. Materials and Methods: This was a prospective, cross-sectional study conducted over a period of 6 months from January 2019 to June 2019. MRI scans were done for 400 patients aged 18 years and above presenting with LBP and no history of lumbosacral spine surgery, trauma or any contraindication to MRI investigation. Subjects were those referred to the department of radiology from orthopedic clinic, general outpatient clinic, and other hospitals or from the relevant wards of the hospital for lumbosacral MRI on the account of chronic LBP. The MRI scan was performed on the subjects in sagittal, coronal, and axial planes using G.E Healthcare Medical System (Signa Excite MR 1001) MRI machine with an open magnet of 0.35 Tesla strength. The variables recorded were expressed as mean (±standard deviation), mode and range while comparison and correlation of variables were done using the Pearson’s Chi-square test with significance level set at 0.05. International Business Machines statistical package for the social sciences (SPSS) version was used for data analysis. Results: A total of 400 patients were recruited for this study, with an age range of 18–87 years out of which 194 (48.5%) were male and 206 (51.5%) were female. The most common primary degenerative imaging finding in the lumbosacral spine of patient with chronic LBP was disc protrusion 340 (85.0%). The most common site for degenerative disease was L4/L5 694 (29.5%) followed by L5/S1 595 (25.3%). Unskilled workers constituted the modal group of subjects that presented with chronic LBP; 110 (27.5%). There was significant association between age and all forms of degenerative disease; P = 0.000, except for extrusion and spondylolisthesis with P = 0.033 and P = 0.002, respectively. Manual skilled workers were the most common occupational group with degenerative spine findings with statistical significance (disc protrusion, Modic changes, Schmorl’s node, and spondylosis with P = 0.003, P = 0.006, P = 0.010, and P = 0.000, respectively), but disc extrusion and spondylolisthesis were not statistically significant ( P = 0.160, P = 0.106). Gender did not significantly influence the study findings ( P = 0.275, P = 0.496, P = 0.136, P = 0.285, P = 0.412, P = 0.717). Conclusion: Disc protrusion was the most common finding in the lower lumbar region of patients with chronic LBP. There was significant correlation between degenerative lumbosacral MRI findings with age and occupation. Gender did not significantly influence the findings.