Disc Prolapses In The Spine on Magnetic Resonance Imaging (original) (raw)
Related papers
2020
Background: Lumbar disc prolapse is one of the common causes of low back pain seen in active people. There are different reports regarding the clinical significance of various magnetic resonance imaging (MRI) findings observed in these patients. The study was conducted to correlate the clinical features and MRI abnormalities. Methodology: This prospective study was carried out in department of Orthopaedics, in tertiary referral centre, for a year. Eighty six clinically diagnosed patients of lumbar disc prolapse were included in the study. They had a complete lumbar spine MRI with 3 tesla scanner. Clinical evaluation included pain distribution, neurological signs and symptoms. The MRI findings were then correlated with clinical signs and symptoms. Results: This study included 86 patient, mean age 41years ± 8.790, male to female ratio 1.2:1 and 49 patients (57%) were heavy workers. All patients presented with low back pain and radicular leg pain. Straight leg raising test was positive...
ASSOCIATION BETWEEN CLINICAL FEATURES AND MRI FEATURES IN PATIENTS WITH DISC PATHOLOGY
MRI is goldstandard for the diagnosis of lumbar disc pathology, but cost is out of reach for patients espacialy for labores, moreover MRI units are very limited in govement sector hospitals and patients have to wait for many days for MRI of spine with disabling pain. Objective of this study was to measure association between clinical features and MRI findngs in patients with lumbar disc prolapse. 50 patients with suspecting lumbar disc prolapse and sciatica were included in study. Index tests in clinical examination were bowstring test, nerve root compression sign of sensory and motor deficit and nerve root tension test (SLR). Reference test was MRI scane and evaluated by a radiologist. Descriptive statisticsabd chi square test was used to analyze data. Study was conducted on laborers, 8% were factory worker, 28% were construction worker and 60% were measons. 70 % patients shoewed positive MRI finding examined by radiologist. In clinical examination 72% patients showed positive bowstring test conducted by physiotherapist. Nerve root tension test was positive in 62 % participants. Nerve root compression sign of sensory and motor deficit was positive in 16 % patients. Pearsons chi square test between MRI finding and clinical finding were highly associated (pearson chi-square 10.884, 21.542 and 4.082 for bowstering test, nerve root tension test and nerve root compression sign of sensory and motor deficit respectively). MRI finding and clinical finding are associated in patients with disc prolapsed patients.
The limited protocol MRI in diagnosis of lumbar disc herniation
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006
To assess agreement in detection of lumbar disc herniation (LDH) between limited and full protocol MRI. 123 patients who requested lumbar MRI for diagnosis of disc herniation were assessed The full protocol MRI composed of sagittal T1-wi, sagittal T2-wi and axial T2-wi was performed on each patient. The sagittal T2-wi was selected as the limited protocol MRI. The limited and full protocols MRI of each patient were separately interpreted by three neuroradiologists to assess disc herniation and nerve root compression. The consensus results of limited and full protocol were compared. The diagnostic performance of each protocol was analyzed using surgery as the gold standard. There were 62 females and 61 males enrolled into the study between the age of 21-60 years old (means = 42.91 years). The duration of pain was 1-204 months (mean = 31.20 months). The degree of severity was mild in 23.58%, moderate 45.52% and severe 30.89% of cases. Thirty-three cases were operated on. For detection ...
Asian Spine Journal, 2014
Study Design: Case-control. Purpose: Evaluate clinical and imaging factors which may predict the risk of failure of medical therapy in patients with lumbar disc herniation (LDH). Overview of Literature: LDH is a common cause of low back pain and radicular leg pain, with a generally favorable natural course. At present, however, it is not possible to identify patients who may be candidates for surgery in an early stage of their disease by means of clinical signs or diagnostic imaging criteria. Methods: We designed a study investigating patients with untreated low back pain to assess the predictive value of demographic, clinical or imaging findings in identifying patients who finally would meet the classic current criteria for surgery. Results: Among 134 patients, 80.6% were successfully treated with conservative therapy and 19.4% finally underwent surgery. Sex, occupation, involved root level, presence of Modic changes, osteophytes or annular tears were not significantly different between the 2 groups, while cerebrospinal fluid block, Pfirrmann's grade, location of herniation with regard to the midline, and type of herniation were significantly different. Anteroposterior fragment size was significantly higher and intervertebral foramen height and thecal sac diameters were significantly lower in the surgical group. Conclusions: Although it is strongly recommended to practice conservative management at first for patients with LDH symptoms, the results of this study shows that higher Pfirrmann's grade, more laterally located discs, extrusion and protrusion herniation types, and larger fragments could predict the risk of conservative treatment failure. This way, unnecessarily prolonged conservative management (beyond 4-8 weeks) may be precluded.
Magnetic resonance imaging of the spine: An initial experience
Annals of Saudi medicine, 1994
Retrospective analysis was carried out for 447 magnetic resonance imaging (MRI) studies of the spine. The overall mean age +/- SD of the entire series was 38.7 +/- 12.9 years. Degenerative spinal lesions and prolapsed intervertebral disks were detected in 62% and 73% of all the studies and of those which showed spinal abnormalities respectively. Postoperative granulation tissue was the third most common abnormality detected (12%). MRI was superior to computed tomography (CT) and CT myelograms in the diagnosis of disk prolapse (97% versus 66%), degenerative disease of the spine (94% versus 48%), and postsurgical granulation tissue (100% versus 6%). Comparing the numbers of CT and CT myelograms requested in the year prior to the installation of the MRI to the numbers requested during the year where the MRI was functioning did not show any change in the frequency of ordering CT studies. We conclude that our hospital-based series has shown an interesting pattern for spinal disorders. Th...
Natural history of extruded lumbar intervertebral disc herniation
The Journal of Medical Investigation
We studied the natural history of extruded lumbar intervertebral discs using MRI. Forty-nine patients with lumbar disc herniation were included in this study. Ages ranged from 19 to 57. On the T2-weighted sagittal MR image, the signal intensity in the herniated mass was measured and the ratio to that in the original nucleus (i.e., nucleus pulposus from which they extruded) was calculated (signal intensity ratio; SIR). The relationship with SIR and duration of illness was evaluated. In ten patients who were re-examined by MRI after conservative treatment, the size of the herniation measured by T1-weighted axial MR image was compared before and after treatment. The signal intensity of HNP became higher than that of the original nucleus immediately following herniation and thereafter decreased with time, suggesting that initial hydration of the HNP occurred shortly after herniation followed by dehydration of the HNP. The size of the HNP with a SIR value of 1.2 and higher on T2-weighted...
The Professional Medical Journal, 2018
September 2013 to February 2015. Material and Methods: We evaluated two hundred and eleven patients. All patients with either gender and age who presented through outpatient department, with clinically and radiological diagnosed lumbar disc prolapsed were included in the study. Patient profile like name, age, sex, occupation like driver, barber, carpenter, labourer, office worker and those with systemic diseases were documented on predesigned Proforma. MRI Lumbosacral spine done in all patients. Data was analyzed using SPSS version 20.02015. Results: 211 patients were recruited in this study. Out of which 145(69%) were male and 66(31%) were female. In our study 97(46%) were in age ranges of 31-40 years, followed by 63(30%) in 21-30years, followed by 29(14%) in age group. Long route drivers on bad roads had common disc herniation 66(31%) followed by labour (moderate to heavy weight lifting) 42(20%), carpenters 27(13%), barbers 23(11%) and office workers 19(9%). Conclusion: Middle age working male was more prone to develop Lumbar disc herniation, more commonly at L4-l5 and L5-S1 level. Long distance driver, labourer, carpenter, barber and office worker have strong association with lumbar disc herniation.
Lumbar Disk Herniation: A Clinical Epidemiological and Radiological Evaluation
Open Access Macedonian Journal of Medical Sciences, 2022
BACKGROUND: A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. AIM: The study aimed to investigate and observe variation of clinical, epidemiological, and radiological aspects for patients suspected of lumbar herniation based on observed evaluation of CT and MRI imagery. METHODS: This is a cross-sectional study conducted during the periods March 2015 and November 2019. Patients were subjected to MRI and CT based on the emergency or scheduled of diagnose. All MRI scans were obtained with 1.5 tesla MRI machine and for CT had undergone examinations with one of the following equipment: Siemens with 128 slice and Phillips 64 slice. The patients were placed in supine position. RESULTS: Overall 194 symptomatic patients were recruited as a participant in this study, 118 men and 76 women with an average age of 44.9 ±10.4 years. Patients belong to the active age (35-44-years-old and 45-54-yearsold) appeared to have the highest percentage of lumbar disk herniation (LDH) 30.9% and 25.8%, respectively. There were a significant association between such as epidemiological data (such as gender, BMI, age groups, and employment status) and presence of LDH, p ˂ 0.05. Acute pain was presented in 69.07% of patients and according to complaint associated with low back pain (LBP), most of them 47.4% appeared with Right Sciatica. MRI is the most diagnostic methods used in evaluation of LDH in 52% of patients, and CT was used in 48% of them. The most common changes were between L2-L3, L3-L4, and L4-L5. Furthermore, the grading findings which corresponding to lumbosacral segment were Grade I and Grade II. Grade V was less common. CONCLUSION: This study involving patients with lumbar disk herniation and associated LBP showed that a combination of clinical features and epidemiological predicted the presence or absence of a significant association. Further research is required to validate these findings in different types of LDH and LBP for other findings and conditions.