MAGNETIC RESONANCE IMAGING PATHOLOGICAL EVIDENCE IN PATIENTS WITH LOW BACK PAIN IN SOUTHWEST NIGERIA

Area of Science:

• Radiology
• Orthopedics
• Epidemiology

Background:

• Low back pain is a global health issue causing significant disability and economic loss.
• Modifiable risk factors for low back pain are increasingly recognized.
• Magnetic resonance imaging (MRI) is the preferred diagnostic tool for evaluating low back pain.

Purpose of the Study:

• To determine the prevalence and distribution of spinal changes in native Africans with low back pain using MRI.
• To understand the biomechanics of MRI-identified disco-osseous abnormalities in this population.

Main Methods:

• Retrospective study conducted at University College Hospital, Ibadan, Nigeria.
• Evaluation of lumbosacral spine MRI (T1W, T2W sagittal/axial, post-contrast) in low back pain patients.
• Analysis of pre-defined spinal changes including disc, osseous, ligamentum flavum, and facet joint abnormalities.

Main Results:

• 96.3% of 108 low back pain patients exhibited abnormal MRI findings.
• Multiple disc abnormalities were common (75.3%), with disc bulge (79.8%) and dehydration (74.0%) being most frequent.
• The L4/5 disc level was most affected by dehydration, herniation, and nerve root compression; L4 and L5 vertebrae showed endplate changes.

Conclusions:

• MRI reveals prevalent multi-level disc and osseous pathologies in low back pain patients.
• Disc abnormalities predominate, particularly at the L4-5 and L5-S1 levels.
• The L4 vertebra body is also a commonly affected site in this native African cohort.