Utility of Limited Protocol Magnetic Resonance Imaging Lumbar Spine for Nerve Root Compression in a Developing Country, Is It Accurate and Cost Effective?

Hilal, Kiran; Sajjad, Zafar; Sayani, Raza; Khan, Dawar

Abstract

STUDY DESIGN: Cross sectional study. PURPOSE: To determine the accuracy of the screening magnetic resonance study of the lumbar spine in the diagnosis of nerve root compression in cases of low back pain as compared to the routine magnetic resonance imaging (MRI) study of the lumbar spine. OVERVIEW OF LITERATURE: No local study has been conducted for this purpose. In an international study, the reported sensitivity and specificity of screening MRI lumbar spine protocol in the detection of nerve root compression are 54% and 100% respectively.
METHODS
Patients of both genders older than 20 years of age with low back pain of any duration or any severity who were referred to the radiology department of Aga Khan University Hospital for MRI of their lumbar spine were evaluated. Two sets of MRI imaging were recruited for each patient: one labeled as 'screening' and the other labeled as 'routine'. The findings of screening MRI were compared with the findings of the routine MRI study.
RESULTS
A total of 109 patients fulfilling the inclusion criteria were included in this study. The diagnostic accuracy, specificity and sensitivity of the screening protocol in our study was 100%, 100% and 100%, respectively in comparison with the routine MRI lumbar spine study for the detection of nerve root compression.
CONCLUSIONS
Our data proved that the MRI screening study is a highly accurate tool, and its findings are comparable to the routine study for the detection of nerve root compression especially in cases of lumbar spondylosis.