Cross-sectional study on incidental spinal findings in magnetic resonance imaging lumbar spine of patients with low back pain

Abstract

Background: Incidental finding is an observation, not related to the current medical problem. Various incidental findings can be seen in the lumbar spine (LS) magnetic resonance imaging (MRI) taken for evaluation of low back pain. Aims: To evaluate and analyze the spinal incidental findings in MRI LS of patients with low backache. Settings and Design: A retrospective, cross-sectional analytical study. Materials and Methods: All patients (n = 1269, males: 578, females: 691; mean age: 45 ± 15 years) with low backache, who underwent MRI of the LS at a tertiary care hospital in South India, during a period from January 2011 to August 2015. Two radiologists evaluated these examinations for the presence of incidental findings in consensus. We included fatty vertebral hemangioma (FVH), fatty filum terminale (FFT), extraspinal synovial cyst (SC), Tarlov cyst (TC), enostosis, and limbus vertebrae. Statistical Analysis Used: Calculated the prevalence of incidental findings and analyzed the relationship of these incidental findings with patient demographics. Results: Overall, incidental spinal findings were present in 390 patients (30.7%). FVH was the most common incidental finding (n = 205 patients, 16.16%), followed by extraspinal SC (n = 130 patients, 10.2%), and FFT (114 patients, 9%). A pattern of increasing frequency with age noted in the FVH (P = 0.001), TC (P = 0.017), and enostosis (P = 0.008). There was no significant sex predilection for the incidental findings. Conclusion: Incidental findings are common in LS MRI. Understanding on the nature and prevalence of these lesions is essential for the radiologist, for optimal reporting and for the clinician in appropriate interpretation of radiological reports.