Prevalence of lumbar disc herniation in populations with different symptoms based on magnetic resonance imaging study

Background: Lumbar disc herniation (LDH) is common in aged human beings. This study is to investigate the prevalence of lumbar disc herniation (LDH) in different symptomatic populations attending outpatient clinics based on magnetic resonance imaging (MRI) studies, and to analyze the characteristics, distribution, and treatment strategies thereof.

Methods: Patients who visited our outpatient clinics between January 1, 2022, and December 31, 2022, with complaints of low back pain, either accompanied or unaccompanied by lower limb symptoms (radiating pain, numbness or muscle weakness), were included. All patients underwent comprehensive lumbar spine MRI examinations. The prevalence of LDH in different symptomatic populations, as well as the characteristics, distribution, and treatment strategies of disc herniation were analyzed.

Results: Among 8,161 individuals (3,411 males and 4,750 females), 4,496 were diagnosed with LDH, resulting in a prevalence of 55.1 %. Of these, 683 (15.2 %) individuals underwent surgical treatment. Among all patients, 3,529 exhibited only low back pain symptoms, 1,820 (51.6 %) were diagnosed with LDH, and 201 (11.0 %) received surgical treatment. Additionally, 2,673 patients with low back pain accompanied by lower limb symptoms were identified, with 1,608 individuals (82.1 %) diagnosed with LDH; 319 (19.8 %) underwent surgical treatment. Furthermore, 1,959 patients presented with lower limb symptoms only, 1,068 (54.5 %) were diagnosed with LDH, and 163 received surgical treatment (P < 0.001). The prevalence rate for males was 58.8 %, compared to females with 52.4 % (P < 0.01). The prevalence of LDH exhibited an initially increasing trend, later decreasing with advancing age. L4/5 and L5/S1 were the most commonly affected segments.

Conclusion: LDH prevalence varies among patients with different symptoms, with a higher rate in those presenting with low back pain accompanied by lower limb symptoms. These symptomatic patients also exhibit a higher rate of surgical intervention.