PREVALENCE AND ETIOLOGY OF LUMBAR SPINE ABNORMALITIES IN ADULT PATIENTS USING MAGNETIC RESONANCE IMAGING: A CROSS-SECTIONAL STUDY FROM DISTRICT D.I. KHAN, PAKISTAN

Abstract

Background: Lumbar spine abnormalities comprise a spectrum of degenerative intervertebral disc (IVD) conditions, including disc bulging, disc degeneration, herniation, and annular tears. Magnetic resonance imaging (MRI) is the diagnostic modality of choice for accurately localizing these changes. To determine the prevalence and etiological associations of lumbar spine abnormalities in adult patients using MRI, and to evaluate their distribution across intervertebral disc levels. Methodology: In this cross-sectional analytical study, 218 adult patients (18–80 years) presenting with low back pain and suspected lumbar spine disease underwent MRI on a 0.3T open MRI system (HITACHI) at MRI departments in D.I. Khan City in collaboration with the Apex Institute of Medical Sciences. T1- and T2-weighted sagittal and axial images were independently evaluated by three radiologists. Data were analyzed using IBM SPSS Statistics version 30, and the chi-square test was applied to assess statistical significance. Results: Of 218 patients, 123 (56.4%) were male and 95 (43.6%) were female. Disc bulging was the most prevalent abnormality (51.8%, 113/218, p=0.038), followed by disc degeneration (28.9%, 63/218, p<0.001), herniation (14.2%, 31/218, p=0.009), and annular tears (5.0%, 11/218, p<0.001). The L4/L5 level was most frequently involved (30.7%), followed by L3/L4/L5 (23.4%), L4 (24.3%), and L5 (9.2%). Heavy weight lifting (21.1%), post-traumatic history (14.7%), and age-related factors (28.4%) were the leading etiological associations, and low back pain was reported by 216 patients (99.1%). Conclusion: Lumbar disc bulging was the most prevalent lumbar spine abnormality among adults with low back pain in district D.I. Khan, with the L4/L5 and L5/S1 levels most commonly affected. MRI remains the imaging modality of choice for evaluating intervertebral disc abnormalities owing to its non-invasive nature, superior soft-tissue contrast, and diagnostic accuracy. Keywords: Lumbar Spine; Intervertebral Disc; Magnetic Resonance Imaging; Disc Herniation; Low Back Pain; Disc Degeneration.