The Role of Lumbosacral Spine MRI in Evaluation of The Low Backache of Patients in Mosul City

Background: Low back pain is one of the most common presentation encountered by physicians. Reaching a correct diagnosis and reducing patient's pain is priority. The yield of routine lumbosacral MRI in patients presented with isolated low back pain (LBP) is still vague. Most patients with LBP will show different degenerative changes on MRI. As it is unclear whether surgical treatment of degenerative MRI changes results in reduction of back pain or not, the constraint of doing a diagnostic lumbosacral MRI stays questionable.
Aim: The objective of this study is to assess the causes of the lower back pain with more analysis of gender and age groups distribution.
Methods: We reviewed medical records of all patients presented with LBP and referred by their physicians for lumbosacral spine MRI in Radiation Institute in Mosul city as part of their clinical management. The study period was from March 2024 to February 2025. Only patients with a chief complaint of isolated LBP were included. We obtained the relevant data from the computerized medical files and detailed radiological findings from their MRI reports.
Results: three hundred and six patients (306) matched the inclusion criteria. We reported positive findings in MRI in 283 patients (92.5 %), only 23 patients (7.5 %) had normal MRI findings. Bulge of the intervertebral disc was the most common finding seen in (87.6 %). Positive MRI findings were most evident in the middle-age group (40-60 years old). Among the evaluated conditions, dehydration of the intervertebral disc showed a significant association with gender, with a higher prevalence in females (P = 0.015).
Conclusion: Mosul Iraqi patients presented with LBP have similar worldwide patterns of lumbar degenerative changes. Providing that only 7.5 % of patients with CLBP have normal MRI findings, suggestive that we have a relatively good referral protocol for imaging the truly indicated patients which save the cost effectiveness for the healthcare system and shorten the time on waiting list.