Computed Tomographic, Myelographic, and Operative Findings in Patients with Suspected Herniated Lumbar Discs

Neurosurgery ◽  
1983 ◽  
Vol 12 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Nazih A. Moufarrij ◽  
Russell W. Hardy ◽  
Meredith A. Weinstein
Keyword(s):  
Computed Tomography ◽  
Intervertebral Disc ◽  
Clinical Diagnosis ◽  
Herniated Disc ◽  
Lumbar Intervertebral Disc ◽  
Disc Protrusion ◽  
Ct Myelography ◽  
Computed Tomographic ◽  
Canal Stenosis ◽  
Operative Findings

Abstract Fifty patients presenting with a suspected herniated lumbar intervertebral disc were evaluated with sector computed tomography (CT). Excluded from this series were patients with prior lumbar laminectomy or a clinical diagnosis of lumbar canal stenosis. Forty-six of the patients also underwent preoperative lumbar myelography. All patients subsequently underwent laminectomy. In 40 patients (80%), CT was positive. In the remaining 10 patients (20%), it was negative; in this group the myelogram correctly predicted the lesion in 8 (80%), Sector CT correctly predicted the nature of the lesion in 24 patients (48%), was incorrect in 14 (28%), and gave incomplete findings in 12 (24%). CT was most accurate when it demonstrated a disc protrusion as the only finding. In this group, sector CT correctly predicted the operative findings in 24 of 25 patients (96%). CT was less accurate when spondylitic compression was diagnosed. This study suggests that sector CT is a useful test in the evaluation of patients with sciatica and that, when a soft herniated disc is demonstrated on CT, myelography may be omitted.

scholarly journals Lumbago is different from prolapse of lumbar intervertebral disc

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Wei Zhou ◽  
Yanbo Qiu ◽  
Shaoqiu Zhou ◽  
Wei Zhao
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Lumbar Disc ◽  
Posterior Longitudinal Ligament ◽  
Low Back ◽  
Lumbar Intervertebral Disc ◽  
Disc Protrusion ◽  
Medical Reform ◽  
System Disease

<p>There are many errors found in the content of textbook in National Higher Education.For example:One of the errors found in the“Surgery”version no 418 is about movement system disease section.In chapter 677 Section III,the content misinterpretation of the cause of low back pain is the intervertebral disc protrusion that stimulate the outer annulus and the posterior longitudinal ligament in the sinus nerve fibers.For the past twenty years,feedbacks had been reflected repeatedly to the involved party but no one had admitted the contents of the textbook are wrong.The errors had brought great economy loss,physical and mental pain to patients.Every year,the country has to spend billions of dollars in the waste of medical reform reimbursement.This article is aimed to discuss about low back pain is not due to lumbar disc herniation.</p>

scholarly journals Criteria for selection of patients with lumbar intervertebral disc herniation complicated by spinal canal stenosis

2021 ◽  
Vol 23 (6) ◽  
pp. 828-833
Author(s):  
T. А. Ksenzov ◽  
M. V. Khyzhniak ◽  
A. Ю. Ksenzov ◽  
V. О. Tyshchenko
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Spinal Canal ◽  
Disease Duration ◽  
Spinal Canal Stenosis ◽  
Intervertebral Disc Herniation ◽  
Mri Findings ◽  
Lumbar Intervertebral Disc ◽  
Canal Stenosis ◽  
Lumbar Intervertebral Disc Herniation

Aim – to evaluate clinical and instrumental correlation (MRI data) in patients with lumbar intervertebral disc herniation complicated by spinal canal stenosis for optimizing the indications for differentiated surgical treatment. Materials and methods. Clinical and neurological manifestations and MRI data in 80 patients (men – 36, women – 44), aged 27 to 72 years with a diagnosis of intervertebral disc herniation complicated by spinal canal stenosis were retrospectively analyzed. Depending on the size of the spinal canal, there were 2 groups: the first – with relative spinal canal stenosis (n = 20) – 75–100 mm2, and the second group – with absolute spinal canal stenosis (n = 60) – less than 75 mm2. We examined the correlation between the clinical and neurological presentations and MRI findings. Results. Our retrospective analysis has found that the first group consisted mainly of younger patients (46 years) and with a mean intervertebral disc herniation of 8.35 mm, while the second group included older patients (51.7 years) and the mean size of intervertebral disc herniation was 7.3 mm. The group of relative spinal canal stenosis was dominated by patients with radiculopathy syndrome (70 %) and pain in one lower limb (85 %). Radiculoischemia syndrome (50 %), pain in both lower extremities (33 %), neurogenic intermittent claudication syndrome (46.6 %), knee reflex disorders (58.3 %), pelvic organ dysfunction (11.6 %) were more common in the second group of patients. In addition, the longest disease duration (more than 24 months) was observed among patients of this group. We have found a relationship between pain syndrome (according to VAS), muscle strength, the disease duration and the spinal canal area. Conclusions. The correlation of clinical and instrumental methods of examination in patients with intervertebral disc herniation complicated by spinal canal stenosis allows the indications for differentiated surgery to be optimized.

scholarly journals Diagnostic Imaging in Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Ronaldo C. da Costa ◽  
Steven De Decker ◽  
Melissa J. Lewis ◽  
Holger Volk ◽  
Keyword(s):  
Computed Tomography ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Intervertebral Disc Herniation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Disc Extrusion

Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.

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