Magnetic Resonance Imaging Patterns of the Lumbosacral Spine in Low Back Pain at LASUTH, Lagos: A Narrative Review of Findings and Clinical Implications

Abstract

Background: Low back pain (LBP) is one of the leading causes of disability worldwide and represents a major public health burden. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating spinal pathology because of its superior soft tissue resolution. However, there is limited local data describing the spectrum of MRI findings among patients with chronic low back pain in Nigeria. Objective: To review the spectrum of lumbosacral MRI findings in patients presenting with non-traumatic low back pain at Lagos State University Teaching Hospital (LASUTH). Methods: This hospital-based cross-sectional study evaluated lumbosacral MRI examinations of patients with chronic non-traumatic low back pain. MRI findings including disc degeneration, disc herniation, spinal canal stenosis, foraminal stenosis, ligamentum flavum hypertrophy, facet arthropathy, Modic changes, and nerve root compression were documented. Results: Degenerative spinal changes constituted the predominant MRI abnormalities. Disc degeneration, disc herniation, foraminal stenosis, spinal canal stenosis, ligamentum flavum hypertrophy, and facet arthropathy were the commonest findings. Disc degeneration and exiting nerve root compression demonstrated significant associations with severe pain. Increasing age and longer symptom duration were associated with a higher prevalence of degenerative MRI findings, whereas most abnormalities showed no significant association with body mass index. MRI demonstrated high diagnostic sensitivity (98%) in identifying the underlying causes of low back pain. Conclusion: Degenerative lumbar spine disease is the predominant cause of chronic low back pain among patients undergoing MRI at LASUTH. MRI remains an indispensable diagnostic tool for identifying clinically significant spinal abnormalities and should be considered early in elderly patients and those with persistent or severe symptoms to facilitate appropriate management and improve patient outcomes Keywords: Aetiology, Radiodiagnosis, Low back pain, MRI,