Bryc S, Zelazny S, Losicki M, Orzedała E, Woźnica J
Zakład Neuroradiologii, Akademia Medyczna w Lublinie.
Ann Univ Mariae Curie Sklodowska Med. 1990;45:27-35.
The authors compared the agreement between clinical, radiological and surgical diagnoses in 33 cases of nucleus pulposus prolapse. A complete agreement of diagnoses was obtained in 88% of cases. The mechanism and incidence of different signs and their importance for the diagnosis of nucleus pulposus prolapse are discussed. It should be stressed that the compression of nerve roots recognized on radiculography is not pathognomonic sign of prolapse and may be due to such processes as development of marginal osteophytes in the degenerative disc disease, thickening of the posterior longitudinal ligament, hypertrophy of radicular processes or necks of vertebral arches. In the light of own experiences and data from the literature the authors consider radiculography with Amipaque and computer tomography as the method of choice in cases with suspected disc herniation in the lumbar region.
作者比较了33例髓核突出病例的临床诊断、放射学诊断和手术诊断之间的一致性。88%的病例诊断完全一致。文中讨论了不同体征的机制、发生率及其对髓核突出诊断的重要性。应当强调的是，在神经根造影中识别出的神经根受压并非突出的特异性体征，可能是由于诸如退变性椎间盘疾病中边缘骨赘形成、后纵韧带增厚、神经根或椎弓根颈部肥大等过程所致。根据自身经验和文献数据，作者认为在怀疑有腰椎间盘突出症的病例中，采用碘苯六醇神经根造影和计算机断层扫描是首选方法。
