Diagnostic Value of Computed Tomography in Disc-Root Conflicts: Experience from Pasteur Polyclinic of Bamako and CNOS University Hospital

This prospective descriptive study, conducted from August 2023 to August 2024, evaluated the contribution of Computed Tomography (CT) in diagnosing disc-root conflicts in two major radiology centers in Bamako, Mali: the Pasteur Polyclinic and the CNOS University Hospital. A total of 172 patients were examined, with CT abnormalities detected in 112 cases (65%). The average patient age was 49 years, and males predominated (sex ratio 1.29). Lumbar sciatica was the most frequent reason for consultation (41.1%), followed by chronic low back pain (23.2%) and cervicobrachial neuralgia (9%). CT findings revealed vertebral abnormalities in 58% of patients, mainly osteophytes of the vertebral bodies (29.5%) and vertebral compression (11.6%). Disc pathology was dominated by disc protrusion (55.4%) and bulging (22.9%), with a predominance of lumbosacral involvement (67.8%). Disc-radicular conflicts represented 52.7% of cases, most often at the foraminal site (37.8%). The spinal canal was narrowed in 40% of patients, particularly in those over 55 years. Although MRI remains the reference imaging technique for exploring radiculopathies, CT scanning proved highly valuable in our context, where MRI availability is limited. CT provided a reliable morphological assessment of degenerative, compressive, and bony changes responsible for painful radiculopathies. It remains a practical and essential diagnostic tool for spinal evaluation in resource-limited settings.