Bajpai Jeetendra, Saini Sumit, Singh Rakhi
Department of orthopaedics, Vivekanand polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
J Craniovertebr Junction Spine. 2013 Jan;4(1):16-20. doi: 10.4103/0974-8237.121619.
Low backache (LBA) is one of the most common problems and herniated lumbar disc is one of the most commonly diagnosed abnormalities associated with LBA. Disc herniation of the same size may be asymptomatic in one patient and can lead to severe nerve root compromise in another patient.
To evaluate correlation between the clinical features of disc collapse and magnetic resonance imaging (MRI) finding to determine the clinical importance of anatomical abnormalities identified by MRI technique.
From January 2010 to January 2012, 75 otherwise healthy patients (43 males 32 females) between the age of 19 and 55 years (average age was 44.5 years) with low back pain and predominant complaint of root pain who presented to our clinic were included in the study.
Proper screening was done to rule out previous spine affection and subjected to MRI.
The results were analyzed under four headings viz. disc herniation, disc degeneration, thecal sac deformation and neural foramen effacement. All patients had a visual analog score (VAS) score more than 6. The interrater correlation coefficient kappa was calculated to be k=0.51. There were total 44 patients with herniation, 25 patients had mild, one patient had moderate degree of thecal sac deformation, 21 patients had one or more levels of foraminal effacement by the herniated tissue, 100% of the patients had disc degeneration ranging from grade 1 to 3 at different levels; and 48 patients (64%) had radiculopathy, six (8%) patients had bilateral and others had ipsilateral affection.
In our study, the correlation was made between clinical findings and MRI findings. It can safely be concluded that treating physician should put more emphasis on history, clinical examination, and make the inference by these and then should correlate the clinical findings with that of MRI to reach a final diagnosis.
下背痛(LBA)是最常见的问题之一,腰椎间盘突出症是与下背痛相关的最常被诊断出的异常情况之一。相同大小的椎间盘突出在一名患者中可能无症状,而在另一名患者中可能导致严重的神经根受压。
评估椎间盘塌陷的临床特征与磁共振成像(MRI)结果之间的相关性,以确定MRI技术所识别的解剖学异常的临床重要性。
2010年1月至2012年1月,本研究纳入了75例年龄在19至55岁(平均年龄44.5岁)之间、身体健康、因下背痛且主要主诉为神经根痛而前来我院就诊的患者(43例男性,32例女性)。
进行了适当的筛查以排除既往脊柱疾病,并接受了MRI检查。
结果在四个标题下进行分析,即椎间盘突出、椎间盘退变、硬脊膜囊变形和神经孔狭窄。所有患者的视觉模拟评分(VAS)均超过6分。计算得出评分者间相关系数kappa为k = 0.51。共有44例患者有椎间盘突出,25例患者为轻度,1例患者有中度硬脊膜囊变形,21例患者有一个或多个节段的神经孔被突出组织压迫,100%的患者在不同节段有1至3级的椎间盘退变;48例患者(64%)有神经根病,6例(8%)患者为双侧受累,其余为同侧受累。
在我们的研究中,对临床发现与MRI结果进行了相关性分析。可以有把握地得出结论,治疗医生应更重视病史、临床检查,并据此进行推断,然后应将临床发现与MRI结果相关联以得出最终诊断。