EVALUATING DIFFERENT LEVELS OF DISC BULGES OF THE LUMBAR SPINE WITH LOW BACK PAIN THROUGH MRI IN THE POPULATION OF DERA ISMAIL KHAN, PAKISTAN

Abstract

Background: Low back pain (LBP) is one of the most common debilitating conditions and is frequently associated with lumbar disc bulges. Magnetic resonance imaging (MRI) plays a vital role in identifying disc bulges and determining their association with pain severity. Objective: To evaluate the frequency of lumbar disc bulges at various levels of the lumbar spine using MRI among the population of Dera Ismail Khan, Pakistan, and to assess their association with the severity of low back pain. Methods: A descriptive cross-sectional study was conducted among residents of Dera Ismail Khan, Pakistan. Data were collected through a questionnaire and lumbar spine MRI scan reports. Low back pain severity was assessed using the Modified Brief Pain Inventory (BPI). Participants were selected through a convenience sampling technique according to predefined inclusion and exclusion criteria. Data were analyzed using SPSS software, and Pearson’s chi-square test was applied to determine associations. Results: A total of 384 patients were included, comprising 52.9% males and 47.1% females. The mean age of patients experiencing low back pain was 42 years. The most frequent levels of lumbar disc bulges were L5-S1 (24.7%), combined L4-L5 and L5-S1 (24.2%), and L4-L5 (18.8%). Severe low back pain was reported by 84.0% of patients across all disc bulge levels and was particularly common among patients with multiple-level disc bulges. Moderate pain was most frequently observed in patients with disc bulges at L4-L5 and L5-S1 levels. Among patients without lumbar disc bulges, 15.9% reported mild low back pain. Mild pain was reported by 21.7% of patients with combined L4-L5 and L5-S1 disc bulges and by 27.5% of patients with L5-S1 disc bulges. Severe low back pain was more prevalent among females (57.4%) than males (42.6%), whereas mild low back pain was more common among males (71.0%) than females (29.0%). Conclusion: The findings indicate that lumbar disc bulges at multiple spinal levels are associated with greater pain severity compared to single-level disc bulges. The L5-S1 and combined L4-L5/L5-S1 levels were the most frequently affected sites among patients with low back pain