Evaluation of Magnetic Resonance Imaging in the detection of lumbar disc herniations in relation to clinical signs

Introduction: In clinical practice, the diagnosis of lumbosacral radiculopathy involves clinical neurological examination and imaging examination. Clinical neurological tests include sensory, motor, reflex, neurodynamic testing. The MRI examination is the most informative method in the diagnosis of disc herniation, especially for determining the presence, location, shape of the herniation. The role of MRI in the diagnosis of radiculopathy is limited, by visualizing only disc herniations and spinal canal stenosis. Material and methods: The study included 51 patients with signs of lumbar neurocompressive syndrome. All patients underwent a clinical neurological examination in the Department of Neurosurgery and an MRI examination of the lumbar spine that was performed using a Siemens Magnetom Skyra machine. Results: Multivariate analysis suggested a correlation between disc protrusions and gait disorders, but the significance threshold was only 10% (p < 0.10%). Disc extrusions, however, demonstrated a significant correlation with gait disturbances and loss of sensation in the lower limb (p < 0.05%). The multivariate analysis of disc extrusions at various levels revealed a significant correlation between L4-L5 and L5-S1 intervertebral disc extrusions with gait disorders (p=0.042) and muscle weakness in the lower limb (p=0.019). Conclusions: Indications for performing MRI are found to be lumbar pain, sensory deficit, and motor weakness. Specific clinical tests, neurological examination, examination of osteotendinous reflexes, Lasegue maneuver, determination of sensory disorders and of motor deficit are recommended to precise the indications. In the absence of neurological disorders, the MRI examination is not recommended.