Correlation between centralization or peripheralization of symptoms in low back pain and the results of magnetic resonance imaging

Background. One of the main reasons for low back pain is displacement of the nucleus pulposus within the intervertebral disc and spinal canal. In the diagnosis of low back pain a clinical examination is essential, supplemented by magnetic resonance imaging (MRI). The main purpose of our research was to demonstrate that the results of a functional diagnosis based on the McKenzie protocol, when compared to abnormalities found in MRI, allow for more efficient management of conservative therapy. Material and methods. Our clinical material consisted of 98 patients, divided into 2 groups according to whether the symptoms observed were centralized (group A) or peripheralized (group B). The results of the clinical examination was compared with MRI examinations. Results. In order to assess treatment effectiveness and prognosis in low back pain with MRI findings, a precise analysis was done. Three groups were distinguished: 49 patients had herniation and extrusion of the nucleus pulpous, but the annulus fibrosus and the fluid reserve were intact; 46 patients had extrusions or sequestrations, along with stenosis of the spinal canal; 3 patients had no pressure on the nerve roots. Conclusion. Centralization usually implied that the annulus fibrosus would be intact in MRI examination. In these cases the MRI revealed herniations. Centralization also occurred in cases of extrusions where the spinal canal was wide, and the liquid reserve was preserved. Peripheralization occurred in cases of sequestration and extrusions when there was stenosis of the spinal canal.liquid reserve was preserved. 2. Peripheralisation occurred in the cases of sequestration and extrusions when spinal canal was narrow.