Enhanced diagnostic value of adding 3D MR neurography sequence to routine lumbar spine MRI protocol: A retrospective study.

Background: This study evaluates whether the inclusion of a 3D MR neurography sequence in the routine lumbar spine MRI protocol improves the diagnostic yield in patients presenting with low back pain, radiculopathy, or limb weakness. Methods: A total of 277 lumbar spine MRIs with positive MR neurography findings were retrospectively reviewed. Standard MRI images (excluding neurography) were first categorized as normal, nearly normal, or abnormal. Subsequently, MR neurography findings were categorized into five groups i.e. Insignificant findings, Findings that increased diagnostic confidence in standard MRI results, Improved appreciation of disease severity, helped in better delineation of symptomatic site in multilevel disease, and those with significant findings seen only on MR neurography.Statistical analysis was conducted using a two-sample proportion z-test to compare the diagnostic value of standard MRI alone versus MRI with neurography. Results: The addition of MR neurography increased diagnostic yield in over 87 % of cases (241/277 patients). Furthermore, in 20.5 % of cases (57/277), pathology was identified exclusively on MR neurography. Conclusion: Adding MR neurography to routine lumbar spine MRI significantly enhances diagnostic accuracy, offering a symptom-targeted evaluation of spinal nerves. This addition holds promise for improving the workup of patients with low back pain.