Kanaan Tareq, Alisi Mohammed, Anasweh Yara, Yousef Noor, Al-Sabbagh Qussay, Hadidi Fadi, Al-Shudifat Abdul Rahman
Department of Special Surgery, Division of Neurosurgery, School of Medicine, The University of Jordan, Amman, Jordan.
Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman, Jordan.
Orthop Res Rev. 2020 Sep 15;12:139-143. doi: 10.2147/ORR.S265905. eCollection 2020.
The role of routine lumbosacral MRI in patients presented with isolated chronic low back pain (CLBP) is still unclear. Most patients with CLBP will show diverting degenerative changes on MRI. As it is uncertain whether surgical treatment of degenerative MRI changes results in alleviation of back pain or not, the necessity of doing a diagnostic lumbosacral MRI remains questionable. This study aimed to evaluate the yield of lumbosacral MRI among Jordanian patients presented with isolated CLBP.
We reviewed medical records of all patients who presented to neurosurgery outpatient clinic at Jordan University Hospital from December 2016 to December 2019. Only patients with a chief complaint of isolated CLBP were included. We obtained the relevant data from the computerized medical files and detailed radiological findings from their MRI reports.
One hundred and sixty-seven patients (167) matched the inclusion criteria. We reported positive findings in MRI in 112 patients (67%), but 55 patients (32.93%) had normal MRI findings. Dehydration of intervertebral disc was the most common finding. Positive MRI findings were most evident in the middle-age group (41-60 years old). Disc protrusion finding in middle-aged females was significantly less prevalent than males (P = 0.012).
Jordanian patients presented with CLBP have similar worldwide patterns of lumbar degenerative changes. Providing that near one-third of patients with CLBP have normal MRI findings, we suggest following a streamlined protocol for imaging of patients presented with CLBP to reduce healthcare costs.
常规腰骶部磁共振成像(MRI)在单纯慢性下腰痛(CLBP)患者中的作用仍不明确。大多数CLBP患者在MRI上会显示出转移性退变改变。由于退变MRI改变的手术治疗是否能缓解背痛尚不确定,因此进行诊断性腰骶部MRI的必要性仍值得怀疑。本研究旨在评估约旦单纯CLBP患者腰骶部MRI的诊断价值。
我们回顾了2016年12月至2019年12月在约旦大学医院神经外科门诊就诊的所有患者的病历。仅纳入以单纯CLBP为主诉的患者。我们从计算机化医疗文件中获取相关数据,并从他们的MRI报告中获取详细的影像学结果。
167例患者符合纳入标准。我们报告112例患者(67%)MRI有阳性发现,但55例患者(32.93%)MRI结果正常。椎间盘脱水是最常见的发现。MRI阳性发现在中年组(41 - 60岁)最为明显。中年女性椎间盘突出的发生率明显低于男性(P = 0.012)。
约旦CLBP患者的腰椎退变改变模式与全球相似。鉴于近三分之一的CLBP患者MRI结果正常,我们建议对CLBP患者采用简化的影像学检查方案,以降低医疗成本。