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Abstract
Background: Many adults experience pain in the lower back, making it a very common orthopedic disorders and is typically linked with degenerative changes in the lumbar intervertebral discs. Disc bulge signifies an early indicator of disc degeneration that can evolve to herniation or spinal canal stenosis if not diagnosed early. MRI provides high-resolution images of spinal structures and is classified as the reliable standard for assessing intervertebral disc abnormalities due to its enhanced soft-tissue differentiation and non-ionizing nature.
Objective: To evaluate the diagnostic utility of lumbar spine MRI in the assessment of intervertebral disc bulge in adults presenting with low back pain.
Methodology: This descriptive cross-sectional research was carried out at Shareef Medical City Hospital on 113 adult patients referred for lumbar spine MRI. Demographic and clinical data were recorded. MRI findings were analyzed for the presence of disc bulge, level of involvement, type of bulge, disc desiccation, thecal sac indentation, and nerve root compression. Data analysis was carried out in SPSS version 26 and associations between variables were assessed through the Chi-square test.
Results: Among the 113 participants, 89 individuals (78.8%) exhibited disc bulging. The L4–L5 segment was the most commonly affected (45.1%), followed by L5–S1 (11.5%). Most bulges were classified as non-compressive circumferential types (41.6%). Disc dehydration was observed in 93.8% of participants and nerve root impingement occurred in 47.8%. Analysis using the Chi-square test demonstrated a significant association between patient age and disc dehydration (p = 0.006) and between bulge morphology and nerve root compression (p = 0.007).
Conclusion: Magnetic resonance imaging (MRI) is commonly employed to assess intervertebral disc disorders in adults, with the L4–L5 and L5–S1 levels being affected most frequently. The frequent observation of broad-based disc bulge, along with disc desiccation and thecal sac indentation reveals the MRI importance in detecting early degenerative changes. No significant association was found between pain intensity and disc desiccation. Comprehensively, the high soft-tissue resolution of MRI enables accurate assessment of disc bulge.