Low back pain often affects the economically active population with repercussions in world productivity. MRI defines the diagnosis easily with high specificity, allowing the most adequate treatment to be initiated. We undertook this study to confirm the diagnostic sensitivity and specificity of MRI in the evaluation of degenerative lumbosacral disease with facet joint participation.
In a 6-month period we studied 358 patients with low back pain and/or sciatica due to degenerative disorders. We performed a basic evaluation on the clinical characteristics of pain. Plain sequences (T1 and T2) were used on axial, sagittal and coronal planes with MR equipment (0.5 T), evaluating the degenerative modifications of the lumbosacral region.
Discal degeneration associated with multidirectional bulging of annulus and extrusion and protrusion of discal material affected mostly L4-L5 and L5-S1 levels. The same levels showed most degenerative changes on facet joints. The most relevant result in our study was articular facet joint disease present in all cases regardless of the association with intervertebral osteochondrosis, discal hernia and spinal stenosis.
Diagnostic value of MRI in the study of low back pain offers a reliable evaluation with high sensitivity and specificity, in order to make appropriate therapeutic decisions.