Comparision between MR imaging and operative findings in lumbar disc herniation.

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As a part of a series of investigations on the usefulness of MRI in the evaluation of the spinal disorders, we made a study comparing it with operative findings in lumbar disc herniation.MRI was performed on 19 patients (21 discs) treated by surgery. Using sagittal T2 weighted images, their MRI was classified into 4 types (I, II, III and IV) and compared with operative findings; bulging, protrusion, extrusion and sequestration. We investigated also the migration and location (left or right) of disc herniation.Operation showed all the discs classified as Type III and IV in MRI to be extrusion or sequestration. Of 7 discs with Type I and II images, however, 3 were found to be sequestration. There was a 90% agreement between MRI and operative findings for the direction of migration. For the level and location there was an 86% agreement in multiple disc degeneration and an 100% agreement in single disc degeneration.Although T1 weighted images provided delineation of the herniated disc, an agreement with operative findings was not so good as might have been expected. In this respect T2 weighted images were useful to some extent, but an agreement was 52%.Surgery can therefore be performed without myelography when only one disc is degenerated and MRI is compatible with its clinical findings.
中国・四国整形外科学会の論文