Diagnostic Association of Reduced Lumbosacral Disc Space on X-Ray with MRI-Confirmed Lumbar Disc Herniation

Background: Herniated lumbar discs are common and have been demonstrated as one potential source of low back pain. The lack of definitive diagnostic procedure in the past often made treatment of herniated lumber discs is frustrating and unrewarding but today most of these patients can return to active normal lives. This study aims to establish association between reduced disc space on x-ray of lumbosacral spine and herniated lumbar disc on MRI among the clinically diagnosed patients of herniated lumbar disc. Methods: In this study, data were collected from 31 symptomatic herniated lumbar disc patients admitted to Departments of Neurosurgery at BSMMU (Bangabandhu Sheikh Mujib Medical University) and DMCH (Dhaka Medical College Hospital), Bangladesh, from July 2015 to October 2016. Data analyses were performed with SPSS version 22.0. Descriptive statistics were used to summarise the variables. Results: In present study at L1-L2, L2-L3, L3-L4, L4-L5 and L5-S1 levels disc shows no significant association between reduced disc space in X-ray of lumbosacral spine and MRI of lumbosacral spine in diagnosis of herniated lumbar disc as all p values were above the statistically significant set P value <0.05. On validity test in above levels- sensitivity, specificity, positive predictive value, negative predictive value and accuracy of X-ray in diagnosis of herniated lumbar disc were not statistically significant to prove significant association. Regarding spearman ranks correlation coefficients (rs) were not between -1 to +1, which were not statistically significant.  Conclusion: The present study ascertains that there is no significant association between reduced disc space in x-ray and herniated lumbar disc on MRI among the clinically diagnosed patients of herniated lumbar disc. These results may also be instrumental for the development of further research and segment-specific surgical treatments that are aimed to restore native spine function.