Prevalence of Lumbar Disk Herniation in Adult Patients with Low Back Pain Based in Magnetic Resonance Imaging Diagnosis

Abstract

Background: Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. Approximately 5–15% of patients with low back pain suffer from lumbar disc herniation. Presenting symptoms of lumbar disc degeneration are lower back pain and sciatica which may be aggravated by walking, sitting, standing, bending, lifting etc. Aim: To evaluate based on MRI images the prevalence of LDH in patients with low back pain and its correlation between various demographic data. Methods: This Cross sectional and observational study was conducted from January 2016 to December 2017 at department of Imagery in the University Hospital Center `Mother Theresa`. During the two years’ period of this study, 342 patients of low back pain were presented to department of imagery suspected for lumbar disc herniation. Diagnostic criteria were based upon abnormal findings in MRI. All MRI scans were obtained with 1.5 tesla MRI machine. Data analysis was carried out with SPSS software for Windows version 20.0. Results: Overall 342 patients with LBP came into Imagery department, the prevalence of lumbar disc herniation resulted 31.9% (109/342). Most of patients 60.5% were presented with continuous LBP with a predominance of deterioration of pain by the walking activity 65.2%. The average age of patients with LDH resulted 51.12 years old with min 32 years and max 74 years old. The ratio M:F of LDH patients resulted 1.4, with predominance of males 59.6%. The active age 40-49 years (28.9%) old and 50-59 years (36.9%) were the most affected by LDH compared to other age groups. Based on MRI images disc herniation was most commonly present at the level of L3/L4 and L4/L5. Commonest types of disc herniation were protrusion 63.3% (69/109) followed by extrusion 21.1% (23/109). In the overall multivariate regression analysis, a significant relation between lumbar disk herniation and some of occupation was found (p˂0.05) Conclusions: Biologically, the lumbar herniation disc is a potential contributor to low back pain. The prevalence of LDH among patients with LBP resulted 31.9%, and men were more prone to suffered from disc herniation than women, due to increased mechanical stress and injury. Results reported the frequent occurrence of lumbar disc degenerative disease in active age. The lumbar discs most often affected and leads to herniation are L3-L4, and L4–L5. Research efforts should endeavor to reduce risk factors and improve the quality of life.