Correlation between clinical and imaging finding of symptomatic degenerative lumbar spine disease

Abstract

Background: Back pain resulting from degenerative disease of the spine is one of the most common causes of disability in working age adults. Clinical symptomatology of these patients varies widely with imaging findings. Materials and Methods: This study was conducted in Burdwan Medical College and Hospital. Study Population: Inclusion criteria: (a) Patient age ≥35 years (b) Clinically suffering from degenerative lumbar spine disease (c) Imaging evidence were included in the study. Exclusion criteria: (a) Traumatic lumbar spine, metastatic disease, previous neurovascular pathology, or associated lower limb fractures were excluded from the study. Sample Size: Two hundred patients were included in the study. Study Design: This was an institution-based cross-sectional study. Study Tools: All cases have undergone X-ray, but magnetic resonance imaging has been most effective. Data Analysis: For statistical analysis, we have calculated Chi-square statistic value and P value. Results: In this study, single disc involvement (49.4%) and multiple disc involvement (50.6%) pattern was equally prevalent. For single level disc changes, disc bulge was the most common pathology in our study (75%) followed by disc protrusion (25%). Among the patients with severe degree of nerve compression, 72.9% of patients had claudication. In our study, 81% of patients with anteroposterior (AP) canal diameter <8 mm had distal extremity radiculopathy. In our study, among spinal canal stenosis patients, association of AP canal diameter with motor weakness is found to be statistically significant (P = 0.0229). In patients of degenerative spondylolisthesis (DSL), occurrence of axial back pain and extremity pain as per clinical and radiographic degenerative spondylolisthesis classification (P = 0.0129) correlated well. Conclusion: There has been positive correlation between clinical and imaging finding for severe degree of disc degeneration and spinal canal stenosis but variable for DSL.