Background: Lumbar intervertebral disc herination is a pathological condition in which a tear in the outer fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft central portion (nucleus pulposus) to be extruded to the outside of the disc. It is usually due to the degeneration of the intervertebral disc. It is one of the most common causes of low back pain (LBP) among adults with or without lower extremity symptoms. It has significant economic, social and health impact on affected individuals. OBJECTIVES: The study aims to correlate the anatomic levels and sites of occurrence of lumbar disc herniations with the presenting symptoms and functional disability among adults with low back pain in Enugu urban. Methodology: The study was a clinically based prospective study at National Orthopedic Hospital Enugu and Annunciation Specialist Hospital, Enugu over a 12-month period. Written informed consent was obtained from all the participants. The inclusion criteria were adults 18 years and above who had low back pain and have done lumbosacral spine MRI scan depicting lumbar disc herniation(s). Those who had traumatic spinal cord injury with paraplegia and those who had previous lumbar spine surgery were excluded. Adults who met the inclusion criteria were consecutively recruited. The patients’ MRI scans were viewed using DICOM software on windows® 7 laptop computer and cross checking the findings with the accompanying radiologist report. The data included the patients’ demographics, presenting symptoms, functional disability index for back pain, weight, height, anatomical level(s) and site(s) of the herniated disc material, number of affected levels and duration of the low back pain. The data were analyzed with SPSS version 20.0. The results obtained were subjected to statistical tests and p-value < 0.05 was considered significant. Results: A total of 81 subjects who met the inclusion criteria were included in the study and analyzed. The mean age of the subjects is 52.99 ± 13.13 years. The most common affected age group is 51-60 years (27.2%). Slightly higher proportions were females 43(53%) with a male to female ratio of 1:1.1. Majority of the subjects (64; 79.0%) were either overweight or obese. Majority of the subjects (68; 84%) had their herniations at more than one lumbar intervertebral disc level which usually includes L4 level (74; 91.4%). Majority of the subjects presented with associated sciatica (78; 96.3%) and tingling sensation in the lower limbs (77; 95.1%). However, few subjects had associated loss of bladder and bowel controls (9; 11.1%). Most of the subjects showed moderate to severe (50; 61.8%) disability index. Conclusion: It can be concluded that lumbar disc herniation is usually associated with sciatica and tingling sensation in the lower limbs. Also, that lumbar disc herniation at L4 anatomic level is significantly associated with more functional disability. Again, that central/foraminal sites of disc herniation is significantly associated with herniation at L1 anatomic level.
