EVALUATING THE FREQUENCY OF SCIATICA FEATURES ON MRI IN PATIENTS WITH LOWER BACK PAIN

Abstract

Background: Sciatica is a prevalent condition affecting millions globally, often caused by irritation or compression of the sciatic nerve. It manifests through symptoms such as lower back pain, leg discomfort, numbness, tingling sensations, and muscle weakness. Despite its frequency, sciatica remains misdiagnosed or misunderstood, particularly in patients with lower back pain. Given its high prevalence, accurate diagnosis and management are critical for improving patient outcomes and quality of life.

Objective: To evaluate the frequency of sciatica features on magnetic resonance imaging (MRI) in patients presenting with lower back pain.

Methods: An observational descriptive study was conducted at Farooq Hospital, Lahore, over four months from June to September 2023. A non-probability convenience sampling technique was used to enroll 57 patients of both genders presenting with sciatica symptoms, including back pain radiating to one or both legs and numbness. Exclusion criteria included claustrophobia or a history of non-spinal sciatica causes. MRI scans were performed using a Siemens Magnetom C machine with a 0.35 Tesla strength, utilizing T1-weighted, T2-weighted, STIR sequences, and additional planes to detect spinal pathologies.

Results: Among the 57 patients, 32 (56.1%) were male, and 25 (43.9%) were female, with a mean age of 48.58 years (range: 29–70 years). The most common risk factors were physical inactivity (50.8%), overweight status (42.1%), and diabetes mellitus (29.8%). MRI findings revealed disc herniation in 19 patients (33.3%) and osteoarthritis in 14 (24.6%). Cord compression and degenerative changes were present in 14 (24.6%) and 12 (21%) patients, respectively. The most frequently affected spinal level was L5-S1 (19.3%), followed by L4-L5 (14%) and S1-S2 (12.3%).

Conclusion: This study confirms MRI as an effective diagnostic tool for identifying sciatica-related abnormalities, with disc herniation and osteoarthritis as the leading causes. Lifestyle factors such as physical inactivity and overweight status were the most significant risk factors. The L5-S1 spinal level was the most commonly affected segment, highlighting the importance of targeted diagnostic and therapeutic interventions for patients with lower back pain.