A System for Reporting the Size and Location of Lesions in the Spine

Wiltse, Leon L.; Berger, Paul E.; McCulloch, John A.

doi:10.1097/00007632-199707010-00023

Cited by 67 publications

(40 citation statements)

References 3 publications

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“…Using the classification by zones suggested by Wiltse et al 12 for our evaluation, we found no statistically significant correlation (p=0.902) between facet tropism and the location in the intervertebral disc where the disc herniation occurred. We believed that the greater the facet asymmetry (facet joint with a more coronal orientation), the greater the tendency towards more lateral disc herniation (foraminal or extraforaminal).…”

Section: Correlation Between Facet Tropism and The Location Of Thementioning

confidence: 57%

“…The anatomic location of the lumbar disc herniation in the axial plane, in relation to the location of the vertebral canal in which it occurred, was classified as central, central lateral, foraminal, and extraforaminal, according to the classification proposed by Wiltse et al 12 For this definition, axial cuts of the T1-and T2-weighted MRI exam were used.…”

Section: Methodsmentioning

confidence: 99%

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Influence of Facet Tropism on the Location of Lumbar Disc Herniation

et al. 2018

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Objective: To correlate facet tropism with the side and location of the intervertebral disc in which the lumbar disc herniation occurred. Methods: A retrospective descriptive study that evaluated Magnetic Resonance Imaging of 255 patients with lumbar disc herniation undergoing surgical treatment with the Spine Group of the Hospital Ortopédico de Passo Fundo between 2002 and 2014. The total patient number was stratified according to the side affected by the herniated disc (right or left), location of the hernia in the intervertebral disc (central, centrolateral, foraminal and extraforaminal) and demographic data, such as age, gender etc. The degree of facet joint tropism was measured by the Karakan method and classified as mild (difference less than 7º); moderate (between 7º and 15º) and severe (difference greater than 15º). Results: A statistical significant relationship (p= 0.023) was observed between the facet joint tropism and the side where the lumbar disc herniation occurred. No correlation was found between facet joint tropism and location of the herniation on the intervertebral disc. Conclusions: The degree of facet tropism presents a statistical significant correlation with the side of the intervertebral disc in which the lumbar disc herniation will develop.

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Section: Correlation Between Facet Tropism and The Location Of Thementioning

confidence: 57%

Section: Methodsmentioning

confidence: 99%

Influence of Facet Tropism on the Location of Lumbar Disc Herniation

et al. 2018

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“…The Wiltse system for reporting the size and location of lesions in the spine was implemented. 13 On the sagittal plane we defined superior, middle, and inferior locations for the vertebral segment. The superior area was equivalent to the suprapedicle and the pedicle level according to Wiltse system, while the middle area was equivalent to the infrapedicle level, and the inferior area was equivalent to the disc level according to the Wiltse system.…”

Section: Methodsmentioning

confidence: 99%

Predisposing factors for dural tear in patients undergoing lumbar spine surgery

Smorgick

Baker²,

Herkowitz

et al. 2015

SPI

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OBJECT The purpose of this prospective cohort study was to identify risk factors for incidental durotomies in lumbar spine surgery. The authors hypothesized that the incidence of durotomy would be higher in cases involving multiple operations. METHODS The authors prospectively evaluated 523 patients who underwent lumbar and thoracolumbar spine surgery. They compared data on patients in whom a dural tear occurred and those in whom a dural tear did not occur. Data from patients in whom a dural tear occurred were compared with data from patients who did not experience durotomy. The data included basic demographic information, intraoperative data, and clinical information from a medical record review. RESULTS One hundred thirty-one patients underwent discectomy and 392 patients underwent laminectomy. Among the 131 patients who underwent discectomy 6 patients had a dural tear. Among the 392 patients who underwent discectomy 49 patients had dural tear. Patients with incidental durotomy were older (mean 65 ± 13 vs 60 ± 14 years of age; p = 0.044, t-test), and had longer surgery (146 ± 59 vs 110 ± 54 minutes; p = 0.025, t-test), compared with the patients without dural tear. The incidence of dural tear was more common in patients with a history of previous spine surgery (p < 0.001). CONCLUSIONS In patients who underwent lumbar and thoracolumbar spine surgery for degenerative problems, previous surgery and older age were found to be predisposing factors for dural tear.

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“…8,22 Caudally migrated fragments seem to be more impacted within the root axilla, might be more difficult to remove as the root is tented and fixed on the fragment. Thus, the initial root mobilization is not only difficult but extremely hazardous, and therefore initial generous foraminotomy should be completed before attempting to mobilize the root or address the fragment.…”

mentioning

confidence: 99%

Clinical and Surgical Correlation with MRI Findings in Herniated Lumbar Disc: Towards Clinical and Surgical Application of the Current Classification Oriented Understanding of the Morphology of the Herniated Lumbar Disc

Hamada

AbouZeid

2015

Egyptian Spine Journal

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Background Data: Herniated lumbar discs requiring surgery are evaluated preoperatively by magnetic resonance imaging. This helps the surgeon to appreciate the size, direction and morphology of the herniated disc material and aids planning the surgical procedure. The currently available MRI based classifications and terminology do correlate clinical, surgical and prognostic information. Purpose: Our study aims to find clinical and/or surgical correlation between the morphology of different disc herniations based on MRI findings with correlation to the clinical and surgical findings. Study Design: Retrospective analysis of 117 patients who had lumbar microdiscectomy for single level herniated lumbar discs. Patients and Methods: Preoperative MRI was thoroughly examined and the level, laterality, the presence of High Intensity Zone (HIZ) on T2 MRI and Modic changes were recorded. Furthermore, all disc levels were analyzed using the Michigan University Grading System (MSU), the Pfirmann grading for degree of disc degeneration. We subdivided the fragment according to its base diameter on sagittal MRI into: uniform, protruded, extruded and sequestrated. Noted was the fragment direction. The signal intensity of the herniated material in T2 weighted images was reported. We then correlated using statistical analysis each of the MSU Grade, Pfirmann Grade, fragment morphology, fragment signal and fragment migration with the preoperative duration of symptoms, self-reported Visual Analogue Score for leg pain (VAS), neurological deficit, sphincters dysfunction and straight leg raising, blood loss, incision length, bony work, the amount of disc material removed and the shape of the fragment, length of hospital stay, early postoperative sciatica,

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A System for Reporting the Size and Location of Lesions in the Spine

Abstract: The authors of the present study believe that all health care professionals who care for the spine will find this nomenclature valuable in communicating with each other, in writing medical reports, in presenting reports at meetings, or in writing scientific articles.

Cited by 67 publications

References 3 publications

Influence of Facet Tropism on the Location of Lumbar Disc Herniation

Influence of Facet Tropism on the Location of Lumbar Disc Herniation

Predisposing factors for dural tear in patients undergoing lumbar spine surgery

Clinical and Surgical Correlation with MRI Findings in Herniated Lumbar Disc: Towards Clinical and Surgical Application of the Current Classification Oriented Understanding of the Morphology of the Herniated Lumbar Disc

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