Comparative Study of Lumbar Magnetic Resonance Imaging and Myelography in Young Soldiers with Herniated Lumbar Disc

Abstract

Objective : This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). Methods : Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. Results : Mean patient age was 20.5 ± 1.1. Mean VAS-LBP and VAS-LP were 6.7 ± 1.6 and 7.4 ± 1.7, respectively. Mean ODI was 48.0 ± 16.2%. Mean MRI, MRM, and myelography scores were 3.3 ± 0.9, 3.5 ± 1.0, and 3.9 ± 1.1, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. Conclusion : Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.

A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

“…We evaluated disc degeneration at the surgical level and at the most degenerated level using the Pfirrmann grade on the MRI 7) . The degree to which the nerve roots were compressed by the herniated disc was measured from 1 (minimum) to 5 (most severe) according to Kang et al's report 10,11) .…”

Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

“…In the study by Pfirrmann et al 20) , a grading system was used only for herniated lumbar discs, while in the study of Bartynski and Lin 1) , a different grading system was used for lateral recess stenosis. Kang et al 16) conducted a study that compared MRI, MR myelography, and myelography by using a grading system for nerve root compression. In the study, a modified grading system devised by Pfirrmann et al 20) was used only for patients with lumbar disc herniation.…”

“…In the study, a modified grading system devised by Pfirrmann et al 20) was used only for patients with lumbar disc herniation. The correlation between nerve root compression grades and clinical features assessed by using the VAS and Oswestry disability index was evaluated in the study 16) .…”

Factors Associated With Longer Postoperative Outpatient Follow-up Duration in Patients With Single Lumbar Disc Herniation: A Noncomplicated Patient Cohort Study

“…The clinical factors included the preoperative conservative treatment period, the presence of motor weakness, and the surgical approach (e.g., midline microdiscectomy, paramedian microdiscectomy for foraminal LDH, and percutaneous endoscopic lumbar discectomy). The radiological factors included the disc location (level), disc degeneration (Pfirrmann grade [ 1 ]), and severity of root compression [ 2 ]. Insurance type was used as a proxy for socioeconomic factors, instead of direct measures of occupation, educational level, and income.…”