Evaluation of Lumbar Spine Morphology in Magnetic Resonance Images Using Cobb’s Method

Abstract

Lumbar lordosis is one of the most common postural abnormalities it is defined as increased lumbar curvature in the sagittal plane of the vertebral column. Several different methods are used to measure lumbar lordosis, the Cobb’s method is commonly used for curvature analysis on sagittal lumbar images The objectives of study to evaluate the lumbar spine morphology using cobb’s method in Sudanese subjects, MRI sagittal T2 W images were done using two different MRI Machines Philips Superstar Neusoft medical system 0.35 Tesla and Machine type Siemens, symphony, mastro class 1.5 Tesla. It was conducted in Advanced Diagnostic Center and Baraha Medical City hospital in Khartoum Sudan during the period from August 2015 to August 2016, 140 patients; their ages ranged from 13-90 years. There were 85 female patients and 55 male subjects, Normal population (control) included 40 patients (10 males and 30 females), their mean age was (37.8 ± 13 years), 100 patients had disc herniation at different levels. They included (55 females and 45 males), their mean age was (47.3 ± 15.7 years), the data were collected using many variables, including Age, gender, weight, height, Body mass index, Intervertebral disc space height, Herniated disc, Body height, Angle of lumbar lordosis (Cobb angle). The study results showed that there was significant difference between normal population and patients with disc herniation as regards the cobb angle (p-value 0.000) and intervertebral disc space of L3 (p-value 0.011); while there was no significant difference (p> 0.05) between control subjects and abnormal patient at Lumbosacral Angle, L1-L5 body vertebrae and L1, L2, L4 and L5 IVD levels. Also there was significance difference between Cobb angle and LS angle at abnormal group (p- value 0.045) while no significant difference in control cases (p-value 0.691). In male and female groups there was no statistically significant deference regarding the L.S angle in both groups. In patient with disc herniation at different levels we find there is direct linear relationship between the vertebral body L5-L2 with the Cobb angle, and indirect linear relationship between the intervertebral disc spaces L5-L2 with the Cobb angle, Also an indirect linear relationship between the body diameter L5-L3and disc bulge, and direct linear relationship between the intervertebral discs space diameter and disc bulge at same levels, related to LSA there is indirect linear relationship with disc bulge at L5-SI level. Regarding the control cases results find there is direct linear relationship between the vertebral body and intervertebral disc spaces with the Cobb angle; except at L3 vertebral body level find indirect linear relationship. MRI imaging is ideally suited in identifying pathology related to the soft tissue including the vertebral disks which are most often involved and causing low back pain.