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Magnetic resonance imaging of the lumbar spine in adult: Evaluation of spinal incidental findings in patients with low back pain

Aim: We aimed to incidental findings discovered in patients with suspected low back pain disease undergoing MRI of the lumbar spine and the clinical importance of those findings. 
Material and Methods: One thousand seven hundred fourteen patients included who were admitted to our hospital with a preliminary diagnosis of low back pain were examined. The duration of low back pain complaints of the patients was ranging from 1 week to 4 years. MRI examinations were interpreted by academic neuroradiologists who had 7 years of experience, at the time of the study. 
Results: Overall, 358 patients (20.9%) had incidental findings. Transitional vertebrae was the most common (134 cases, 7.8%) incidental finding, followed by vertebral hemangioma (65 cases, 3.8%) and Tarlov cyst (54 cases, 3.2%). The incidence of fatty filum terminale, compact bone island, spina bifida, synovial cyst and sacral meningocele was 2.1%, 1.5%, 1%, 0.8% and 0.7% respectively. Of these 1714 patients, 329 patients (92.06%) had one finding, 22 patients (5.95%) had two findings, and 7 patient (1.98%) had three findings. 
The conus medullaris was terminated in 1710 (99.7%) of the patients (L1-2) .This level were considered normal. In four cases, the spinal cord was determined to be below the required level. The prevalence of transitional vertebra was 7.8%. The prevalence of sacralization and lumbalization was 5.1% and 2.7%, respectively. 
Conclusion: In this study we showed that incidental findings are mostly benign but interestingly there were no malignant or potentially malignant incidental lesions.