Evaluation of Lumbar Disc Pathologies Using Magnetic Resonance Imaging: Emphasis on Disc Bulging and Neural Compression

Abstract

Lumbar disc bulging is a common spinal condition that contributes significantly to lower back pain, radiculopathy, and functional limitations. Magnetic Resonance Imaging (MRI) provides superior visualization of intervertebral discs and surrounding structures, making it the gold standard for evaluation. This descriptive cross-sectional study was conducted over four months across multiple hospitals in District Peshawar, Khyber Pakhtunkhwa, and included 385 patients aged 18 years and above who presented with symptoms of back pain, radiculopathy, or sciatica and underwent lumbar spine MRI. Data were collected using a structured questionnaire and analyzed through SPSS. The results showed that 23.8% of participants were below 30 years of age, 52.3% were males, and 61.7% were married. Clinical features included pain duration longer than three months in 52.6% of cases, radiation of pain in 46.6%, numbness or tingling in 49.0%, leg weakness in 39.4%, and difficulty in walking or standing in 33.2%. MRI findings revealed that 44.0% had no disc bulging, 18.7% had single-level bulging, 35.2% had multiple-level bulging, and 2.1% had bulging at more than three levels. The most frequent type of disc bulge was diffuse (19.2%), followed by focal (18.4%) and broad-based (16.8%). Disc protrusion was observed in 22.3%, disc extrusion in 25.9%, nerve root compression in 28.0%, and spinal canal stenosis in 25.6% of participants. The study concludes that MRI plays a pivotal role in detecting the level, type, and complications of lumbar disc bulging, thus serving as an essential diagnostic tool for accurate assessment and management planning in patients with chronic back pain and related symptoms.