THE INCIDENCE AND CLINICO-RADIOLOGICAL FINDINGS IN SYMPTOMATIC ADULT PATIENTS WITH LUMBAR DEGENERATIVE DISC DISEASES IN A TERTIARY ORTHOPAEDIC HOSPITAL, SOUTH-WEST, NIGERIA

Abstract

Background: Lumbar Degenerative Disc Disease (LDDD) is a common pathology in adults all over the world. The incidence, knowledge and correlation of clinico-radiological features would be helpful to a physician treating degenerative lumbar spine disease to achieve a better outcome. Objective: To determine the one year incidence of LDDD in National Orthopaedic Hospital Igbobi, (NOHI) Lagos common clinical (symptoms and signs) and radiological findings in adult symptomatic patients with LDDD and to also study the frequency and relationships of clinical features with imaging findings in them. Methods: A cross sectional analytical study of 160 adult symptomatic patients aged 31-60 years with diagnosis of lumbar degenerative disc disease who were recruited consecutively in a spine unit between May, 2016 and April, 2017. The incidence, clinical symptoms, signs and imaging findings were studied and analysed using SPSS version 24. Results: One hundred and sixty adult patients were studied with male to female ratio of 1:1.5, period incidence of 11.5% and mean age of 45.50(±14.50). The most involved lumbar disc in LDDD was L4/L5 (59.6%) while 55.6% of the patients had spondylolisthesis mostly at L4/L5. Almost all the patients (99.4%) had altered sensation symptoms with bilateral radiculopathy in 86.9% of them. Half (50%) of the participants had grade III Kellgren-Lawrence Classification of LDDD. There was a significant statistical relationship between altered sensation, radiculopathy and Modic grade 3 (p values< 0.05). Conclusion: The annual incidence of LDDD was 11.5% in our study. Most patients presenting to hospital with LDDD in our settings are likely to present late with altered sensation, radicular symptoms and are likely to be of Modic grade 3. We therefore recommend that adult patients presenting with low back pain secondary to lumbar degenerative disc disease should be thoroughly investigated and adequately managed since they are likely to present late.