Analysis of the clinical picture in patients with osteoarthritis of the spine depending on the type and severity of lesions on magnetic resonance imaging

• Main Author: Dariusz Lachman
• Format: Article
• Language: English
• Published: Termedia Publishing House 2015-09-01
• Series: Rheumatology
• Subjects: spine; intervertebral disc herniation; magnetic resonance imaging
• Online Access: http://www.termedia.pl/Analysis-of-the-clinical-picture-in-patients-with-osteoarthritis-of-the-spine-depending-on-the-type-and-severity-of-lesions-on-magnetic-resonance-imaging,18,25687,1,1.html

Objectives : Spondyloarthritis is the most common pathological change in the spine. In a significant number of cases, it leads to compression of the nervous structures of the spinal canal, causing pain and neurological symptoms. Intervertebral disc pathology is a common cause of root deficits in neurological examination of all types of degenerative changes of the spine structures. Disc herniation is pathologically divided into 4 stages of herniated nucleus pulposus: 1) bulging, 2) protrusion, 3) extrusion, 4) sequestration. The aim of this study is to analyze the correlation between the type and severity of degenerative changes in the spine and the incidence of neurological deficits. Material and methods: The study included 100 patients: 74 men and 26 women aged 50.2 ±10.43 years with pain of the spine in the cervical and/or lumbosacral segments and with degenerative changes in the plain radiographs. The mean value of body mass index (BMI) was 27.8 ±3.95 kg/m 2 . Each patient underwent neurological examinations and 1.5 T magnetic resonance imaging MRI of the cervical and/or lumbar spine. Results : Every patient was diagnosed with herniated nucleus pulposus affecting on average 4 ±2 segments of the spine. The most frequently observed degree of severity of disc herniation was the second (protrusion, 71.9% of all disc disease in 89 patients). Much less frequently found was the third degree (extrusion, 45 patients, 20.1% slipped disc), the first (bulging, 14 patients, 6.3% slipped disc), and least often only a small percentage of fourth degree (sequestration, 4 patients, 1.7% slipped disc). Neurological symptoms (deficits) were observed in 34 patients. They were accompanied by disc herniations in 23.7% of patients. In remaining patients with neurological deficits there was spinal stenosis. No correlation was observed between neurological deficits and stage 1 of disc herniation. Conclusions : The incidence rate of neurological deficits is correlated with the degree of changes in the spine, as visualized by MRI.