CORRELATION BETWEEN LUMBAR SPINE MRI FINDING AND CLINICAL SEVERITY AMONG PATIENTS WITH SCIATICA

Abstract

Sciatica is a common musculoskeletal disorder characterized by radiating pain along the sciatic nerve, most frequently caused by lumbar disc pathology. Magnetic resonance imaging (MRI) is the preferred imaging modality for evaluating lumbar spine abnormalities; however, the relationship between MRI findings and clinical severity remains controversial. Therefore, the study is conducted to determine the correlation between MRI findings and the clinical severity of sciatica in patients with lumbar spine disorders. The current cross-sectional analytical study was conducted on 138 patients with clinically diagnosed sciatica. Clinical data, including demographic characteristics, symptom duration, pain characteristics, pain intensity, aggravating and relieving factors, and neurological symptoms, were collected using a structured questionnaire. MRI findings, including disc pathology, level of involvement, nerve root compression, spinal canal stenosis, foraminal narrowing, and disc degeneration, were evaluated. Statistical analysis was performed using SPSS version 26. Spearman's rank correlation was used to determine associations between clinical and MRI variables, while binary logistic regression identified independent predictors of nerve root compression. A p-value of <0.05 was considered statistically significant. Among 138 participants, 66.7% were aged 20–50 years and 54.3% were female. Moderate pain was the most common clinical presentation (47.1%), with 55.8% reporting pain radiating below the knee. MRI showed the L4–S1 level as the most frequently affected segment (34.1%), and disc bulge was the predominant finding (39.9%). Nerve root compression (38.9%), spinal canal stenosis (34.1%), foraminal narrowing (24.6%), and disc degeneration (15.9%) were the main MRI abnormalities. Age was significantly associated with nerve root compression, spinal canal stenosis, and foraminal narrowing (p<0.05), while disc pathology showed a strong association with nerve root compression (r = −0.785, p<0.001). Logistic regression identified increasing age (OR=7.67), male gender (OR=2.71), spinal canal stenosis (OR=5.45), and foraminal narrowing (OR=5.45) as independent predictors of nerve root compression.

Keywords: Sciatica, Magnetic Resonance Imaging, Lumbar Disc, Foraminal