Mechanical LBA

LBA with Neurological component

Imaging findings

Osteophytes, disc bulges, annular fissure, Ligamentum flavum hypertrophy, abutting the nerve roots but not impinging or compressing them

Disc extrusion and migration, Disc Protrusion, impingement of exiting nerve roots, compression of traversing nerve roots, Nerve compression, canal stenosis, etc

Symptoms

Inability to stand or sit for a long duration, Pain aggravated while bending forward, Pain is more at the onset of movement. Pain is Comparatively better when the body is warm-recurrent paraspinal muscle spasms.

Radiculopathy pain is relatively constant. Tingling, numbness, paresthesia, pain in lower limbs more than back ache per se with or without bladder and bowel symptoms. Weakness in the affected lower limb is more prominent.

Signs

Paraspinal Muscle Spasm

No signs of neurological compression/irritation

No autonomic involvement

Absent or sluggish reflexes or Hyperreflexia

Sensory motor involvement

Autonomic involvement

Paraspinal muscle spasm

Compression/Irritation of spinal cord or nerve roots

Absent

Present

Anatomical component giving rise to symptoms.

Osteoligamentous complex + IVD + Paraspinal Muscles

Nerve Root/spinal cord In addition to Osteoligamentous complex + IVD + Paraspinal Muscles