Magnetic resonance imaging in the evaluation of the lumbar herniated intervertebral disc

Abstract

Two hundred and eleven patients with lumbar disc herniation at 242 levels were divided into 5 groups by their appearances on magnetic resonance imaging (MRI), and the findings at operation were compared to assess the accuracy of the MRI classification. There were no negative explorations. There was 92% sensitivity, 91% specificity and 92% accuracy for MRI in distinguishing protruded discs from other forms of lumbar disc herniation. For sequestrated discs there was 92% sensitivity, 99% specificity and 97% accuracy. In the extruded subligamentous type there was 71% sensitivity, 82% specificity and 79% accuracy, and 52% sensitivity, 92% specificity and 81% accuracy in the extruded transligamentous type. The overall accuracy of MRI predicting the types of herniated lumbar intervertebral disc was 85%. High resolution MRI is sensitive in detecting disc disease and specific in characterizing various subgroups of disc herniation, especially those which are sequestrated.

Frequency of Instrumentation in Lumbar Spinal Stenosis and Lumbar Disc Herniation

“…Similarly, Branden berg and Traynelis (1999) reported the same levels in 90% of cases. Several other studies published similar findings (17,18,(24)(25)(26)(27)(28). In fact, upper lumbar spine and extra-foraminal space are proportionately larger than the lower lumbar levels, so high mobility leads to early degeneration and herniation of the disc (29).…”

Age and Gender-Related Changes in Radiological Findings of Lumbar Disc Hernia Detected by Magnetic Resonance Imaging

“…Amerikan Nöroradyoloji Derneği, Amerikan Omurga Radyolojisi Derneği ve Kuzey Amerika Omurga Derneği ortak çalışma grubu, disk hernisinin ukleuspulposusun, kıkırdağın, fragmente apofizeal kemiğin veya fragmante anulus fibrosusun intervertabral disk boşluğu sınırları dışına lokalize taşması olarak tanımlamaktadır (1) . Klinik disk hernisi tanısı anamnez ve fizik muayene ile hastalarda manyetik rezonans görüntüleme (MRG) sıklıkla başvurulan ileri radyolojik tetkiklerden birisidir (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) .…”

“…High intensityzone, Posterior anulus içinde halka şeklinde fissür görülmesi olup akut annulerfissürü veya fissüre bitişik alanda disk maddesi içinde vaskülarizegranülasyon dokusunu temsil edebilir (12) . MRG şüpheli LDH tanısını koymada gold Standard görüntüleme olup %97 tanısal doğruluk oranına sahip olup ayrıca gözlemciler arasında yüksek uyum oranı göstermektedir (18,19) . Yaşlanma ve dejenerasyon ile birlikte disklerde su ve proteoglikan kaybederken, kollajen miktarı artarve daha fibröz hale gelirler.…”

Segmentation of the Herniated Intervertebral Discs

“…the annulus fibrosus ruptures resulting in the leakage of the central gel-like material, the nucleus pulposus as shown in the Fig 2a and Fig 2b. In such a disorder, the gel like material puts enough pressure on the spinal nerves and causes swelling or what we call as inflammation of the nerves that are around, which results in severe back pain, radiating pain, and muscle spasm (Milette, Pierre, 2000). As far as diagnosis of intervertebral disc degeneration is considered MR imaging is the modality of choice (Kim et al, 1993). MR does not only help in diagnosis but an accurate segmentation of MR images of intervertebral discs can be helpful in quantification of disc degeneration and hence in a minimally invasive computer assisted spine surgery when needed (Chevrefils, Cheriet, Aubin, Grimard, 2009).…”