Prevalence of lumbar disc herniation and disc degeneration in asymptomatic Indian subjects: An MRI based study

Abstract

Background: India is a country with a huge human resource been utilised for labour and also is a country of diversity in culture and religions. Thus we have numerous activities which involve bending and twisting of the spine. Therefore we expect more disc degeneration and disc herniation compared to the western world. Indian health care system has traditional medicine and modern medicine. Both systems has easy access to Magnetic Resonance Imaging (MRI) which in fact will display both physiological and pathological changes. This may miss-lead a less experienced health worker and can also create a bad mental impact on an otherwise normal individual. Aim: Analyse the prevalence of lumbar disc degeneration and herniation in asymptomatic Indian subjects using MRI. Materials and Methods: this was an observational study where we selected subjects without any low back related symptoms and signs and allowed them to undergo lumbar spine screening using a 0.2 tesla machine. Results: We had 76 subjects with a mean age of 43.7 and studied 380 discs in 4 different age groups. Among disc herniation 273 discs (71.8%) were normal and 107 discs (28.2%) had pathological changes in the form of bulge 68(17.8%), protrusions 30(7.8%) and extrusions 9(2%). None of the subjects had sequestration. Among disc degeneration 256(67.3%) were Grade 1& 2 and 124 (32.7%) were Grade 3, 4&5. In the 76 subjects 37% had disc herniation and 33% had grade 3, 4 and 5 degeneration. Conclusion: The high prevalence of disc degeneration and disc herniation in MRI of normal subjects, emphasize the value of clinical history and clinical evaluation before starting precious treatment.