Magnetic resonance imaging-based interpretation of degenerative changes in the lower lumbar segments and therapeutic consequences

• Published in: World journal of radiology 2015-08, Vol.7 (8), p.194-197
• Main Authors: Maataoui, Adel, Vogl, Thomas J, Khan, M Fawad
• Format: Article
• Language: English
• Subjects: articular; consequences; degeneration; degenerative; disability; injections; lumbar; modalities; spine; standardized
• ISSN: 1949-8470; 1949-8470
• DOI: 10.4329/wjr.v7.i8.194

Intervertebral disc degeneration and facet joint osteoarthritis of the lumbar spine are, among others, wellknown as a cause of low back and lower extremity pain. Together with their secondary disorders they set a big burden on health care systems and economics worldwide. Despite modern imaging modalities, such as magnetic resonance imaging, for a large proportion of patients with low back pain(LBP) it remains difficult to provide a specific diagnosis. The fact that nearly all the lumbar structures are possible sources of LBP, may serve as a possible explanation. Furthermore, our clinical experience confirms, that imaging alone is not a sufficient approach explaining LBP. Here, the Oswestry Disability Index, as the most commonly used measure to quantify disability for LBP, may serve as an easy-toapply questionnaire to evaluate the patient’s ability to cope with everyday life. For therapeutic purposes, among the different options, the lumbar facet joint intraarticular injection of corticosteroids in combination with an anaesthetic solution is one of the most frequently performed interventional procedures. Although widely used the clinical benefit of intra-articular steroid injections remains controversial. Therefore, prior to therapy, standardized diagnostic algorithms for an accurate assessment, classification and correlation of degenerative changes of the lumbar spine are needed.