Magnetic resonance imaging of the lumbar spine in adult: Evaluation of spinal incidental findings in patients with low back pain
Hilal Altas1, Ali Yilmaz2
1Ordu University Faculty of Medicine, Department of Radiology, Ordu, Turkey
2Ordu University Faculty of Medicine, Department of Neurosurgery, Ordu, Turkey
Aim: We aimed to incidental findings discovered in patients with suspected low back pain disease undergoing MRI of the lumbar spine and the clinical importance of those findings.
Material and Methods: One thousand seven hundred fourteen patients included who were admitted to our hospital with a preliminary diagnosis of low back pain were examined. The duration of low back pain complaints of the patients was ranging from 1 week to 4 years. MRI examinations were interpreted by academic neuroradiologists who had 7 years of experience, at the time of the study.
Results: Overall, 358 patients (20.9%) had incidental findings. Transitional vertebrae was the most common (134 cases, 7.8%) incidental finding, followed by vertebral hemangioma (65 cases, 3.8%) and Tarlov cyst (54 cases, 3.2%). The incidence of fatty filum terminale, compact bone island, spina bifida, synovial cyst and sacral meningocele was 2.1%, 1.5%, 1%, 0.8% and 0.7% respectively. Of these 1714 patients, 329 patients (92.06%) had one finding, 22 patients (5.95%) had two findings, and 7 patient (1.98%) had three findings.
The conus medullaris was terminated in 1710 (99.7%) of the patients (L1-2) .This level were considered normal. In four cases, the spinal cord was determined to be below the required level. The prevalence of transitional vertebra was 7.8%. The prevalence of sacralization and lumbalization was 5.1% and 2.7%, respectively.
Conclusion: In this study we showed that incidental findings are mostly benign but interestingly there were no malignant or potentially malignant incidental lesions.
Keywords: Magnetic Resonance İmaging; Incidental Findings; Low Back Pain.