Computed tomography scan findings in low back pain at Kenyatta National Hospital Nairobi

Abstract

A retrospective review of Lumbo-saral spine CT scans done from January 1994 to March 1998 was done. The pattern of abnormal findings was analyzed. In the study period 277 CT Scans of the spine were done. Of these, about 150 were of the Lumbo-sacral Spine. Only 79 cases were available from the X-ray Department records filling section for this study. Seventy of these had ( referral diagnosis indicated on the request form while 9 did not have. The referral diagnosis for Lumbo-sacral spine CT scan were: Low back pain 53(70.8%); Paraplegia 1O( 12.6%); Paraparesis 4( 5.1%); Other diagnosis 3(3.8%); Referral diagnosis missinj 9(11.4%). Seventy four cases had their age indicated while 5 did not have. For those whose ages were indicated abnormal findings were tallied for age and sex. 11 patients had normal CT Scans while 63 had at least one abnormal finding. There were a total of 100 abnormal findings in thes. 63 patients which were categorized into: Lumbar disk disease 42(42%); Facet joint disease 21(21 %); Vertebral body disease 15(15%); Ligamentum flavum hypertrophy 6(6%); Cauda equina tumour 3(3%) and other findings 11(11 %). Of the 79 patients 15 had previously been done plain film myelography. Two were found normal on PFM and on CT one was found to be normal and the other showed a disc bulge. 10 cases had either their diagnosis modified or changed while 3 had the PFM diagnosis sustained.

PFM had nil diagnosis of facet joint disease, hypertrophy of ligamentum flavum, vertebral body disease nor any paravertebral mass. Where disc disease had been noted, it was simply diagnosed as disc herniation. Intrathecal contrast was used in 25(31.6%) of the 79 cases.