Saini Ramavtar, Sharma Anshu, Dave Mirant B
Orthopaedics, Geetanjali Medical College and Hospital, Udaipur, IND.
Cureus. 2022 Jul 25;14(7):e27232. doi: 10.7759/cureus.27232. eCollection 2022 Jul.
Background Lower back pain (LBP) is a major cause of increasing years lived with disability. Many adults suffer from LBP once in their lifetime. Multiple environmental, genetic, and acquired factors lead to disc degeneration. Spinal stenosis can be caused due to bony, ligamentous, or discogenic origin. The majority of cases have a combined etiology of bony, ligamentous, and disc disease. Lumbar disc disease (LDD) has been mentioned by various terminologies in the literature. A standardized nomenclature is needed for better research and communication. Our study is based on the correlation between lumbar disc herniation (LDH) and magnetic resonance imaging (MRI) findings. Methodology A prospective observational study was undertaken on patients presenting with signs and symptoms suggestive of LDD to the Department of Orthopaedics at a tertiary care hospital in southern Rajasthan. The purposive sampling technique with a consecutive scheme was used. MRI is a valuable tool for diagnosing LDH. Results Many studies have concluded false-positive results for MRI in cases of LDH. Hence, interpretation with grading systems (Pfirrmann's and Scizas grading) and correlation with clinical findings are mandatory for accurate diagnosis and management of patients. Conclusions We suggest clinicians adopt clinical reporting of MRI to improve the diagnostic accuracy with clinical and radiological correlation. Reporting can guide professionals in deciding the course of treatment in the form of conservative or surgical management.
背景 下背痛(LBP)是导致残疾生存年限增加的主要原因。许多成年人一生中都会经历一次下背痛。多种环境、遗传和后天因素会导致椎间盘退变。椎管狭窄可由骨质、韧带或椎间盘源性原因引起。大多数病例具有骨质、韧带和椎间盘疾病的综合病因。腰椎间盘疾病(LDD)在文献中有多种不同的术语表述。需要一个标准化的命名法以促进更好的研究和交流。我们的研究基于腰椎间盘突出症(LDH)与磁共振成像(MRI)结果之间的相关性。
方法 对拉贾斯坦邦南部一家三级护理医院骨科出现提示LDD体征和症状的患者进行了一项前瞻性观察研究。采用了连续方案的立意抽样技术。MRI是诊断LDH的重要工具。
结果 许多研究得出MRI在LDH病例中存在假阳性结果。因此,使用分级系统(Pfirrmann分级和Scizas分级)进行解读并与临床发现相关联,对于准确诊断和管理患者是必不可少的。
结论 我们建议临床医生采用MRI临床报告,以通过临床与影像学的相关性提高诊断准确性。报告可以指导专业人员以保守或手术治疗的形式决定治疗方案。