ROLE OF MAGNETIC RESONANCE IMAGING IN EVALUATING DEGENERATIVE LUMBAR SPINE INSTABILITY

Abstract

Background: Lower back pain, it is one of the 10 most frequent reasons for visiting a
family doctor, and at least 85% of the population will experience low back pain at some
point in their lives. Instability here means the absence of stability in a mobile vertebral
segment. This disorder represents the most common cause of work-related disability and
state disability services costs among individuals aged less than 45. Low back pain is a
common clinical condition, and lumbar instability plays an important role in the decision
for surgery, such as vertebral fusion with decompression. Purpose: The purpose of this
study is to determine the magnetic resonance imaging findings suggestive for instability
in the lumbar vertebrae.
Patients and methods: We reviewed the MRI studies of the lumbar spine of 48 patients
with backache who had functional dynamic radiographs proved that they have lumbar
spinal instability. In each study, we classify grade of facet arthropathy, Modic changes,
spondylolisthesis, disc degeneration, and presence of osteophytes and annular tear, and
we correlated between them
Results: We review 48 MRI studies of patients with lumbar instability, 28 (58%) patients
was female and 20 (42%) was male. We found most patients had grades II and III facet
arthropthy (81.2%), grade I Spondylolisthesis (77.1%), Modic changes type II (41.7%),
grade IV and V disc degeneration (75%), annular tear (79.2%), and osteophytes (66.7%).
We found that facet arthropathy has a correlation with the disc degeneration degree (p
<0.05), with the presence of osteophytes (p < 0.0325) and with the most affected segment
(p < 0.001). Likewise, disc degeneration was correlated significantly with the Modic
changes (p <0.01) and with marginal osteophytes (p = <0.01), while no significant
correlation between osteophytes and Modic changes (p> 0.19).
Conclusion: MRI can accurately assess the structures that maintain lumbar stability.