Role of Magnetic Resonance Imaging (MRI) in Diagnosing Etiology of Lower Back Pain and Sciatica in Adult Patients: A Prospective Observational Study

Background: Lower back pain (LBP) is one of the most prevalent musculoskeletal disorders globally, affecting approximately 80% of the population at some point during their lifetime. The condition represents a significant socioeconomic burden due to healthcare costs, work absenteeism, and reduced productivity. Magnetic resonance imaging (MRI) has emerged as the gold standard imaging modality for evaluating spinal pathologies associated with LBP and sciatica. Objective: This prospective observational study aimed to evaluate the role of MRI in diagnosing various spinal pathologies causing lower back pain and sciatica in adult patients, determine the diagnostic accuracy of MRI in localizing pain generators, and assess the correlation between MRI findings and clinical presentations. Methods: A total of 150 patients aged 18-65 years presenting with lower back pain lasting more than three weeks were enrolled in this study. All participants underwent lumbar spine MRI on a 1.5T scanner using standard sequences including T1-weighted, T2-weighted, and STIR sequences. MRI images were independently evaluated by two radiologists. Clinical and demographic data were collected, and statistical analysis was performed using Chi-square tests to assess associations between MRI findings and clinical symptoms. Results: The mean age of participants was 51.71 years, with male predominance (62.66%). Degenerative disc disease was identified in 95% of cases, with the L4-L5 level being the most commonly affected (89.33%), followed by L5-S1 (74.66%). Neural foraminal narrowing was observed in 79.33% of patients, and diffuse disc bulge in 74%. Disc protrusion was present in 36.66% of cases, while spinal canal stenosis was identified in 27.33%. Statistically significant associations were found between neural foraminal narrowing and radicular pain (p<0.001), spinal canal stenosis and neurogenic claudication (p<0.001), and disc protrusion/extrusion with radicular symptoms (p<0.001). Conclusion: MRI is an invaluable diagnostic tool for identifying spinal pathologies in patients with lower back pain and sciatica. The high prevalence of degenerative changes, particularly at the L4-L5 and L5-S1 levels, underscores the importance of MRI in guiding clinical management. The significant correlation between specific MRI findings and clinical symptoms validates MRI's role in accurately localizing pain generators and facilitating appropriate treatment planning