Comparative study of supine and prone flexed posture CT/MRI examination for lumber disc herniation

Abstract

Objective To evaluate the clinical value of prone flexed posture lumber CT/MRI examination for lumber disc herniation. Methods Supine posture CT/MRI (SPCT/MRI) and prone flexed posture CT/MRI (PFPCT/MRI) examinations were performed on 1200 patients with lumber disc herniation.The imaging findings on SPCT/MRI and PFPCT/MRI of each case were compared. According to the CT/MRI diagnostic criteria for encapsulated lumber disc herniation ( HLDH ), adhered lumber disc herniation (ALDH) and ruptured lumber disc herniation ( RLDH), the 1200 cases were divided into three groups. On the basis of PFPCT/MRI findings, 868 cases were selected for percutaneous lumbar diskectomy (PLD) with half to twelve years follow up. Treatment effects of PLD on HLDH, ALDH and RLDH were analyzed with x2test. Results Among 249 ALDH cases diagnosed by SPCT/MRI 35 were identified as HLDH by PFPCT/MRI. Among 163 RLDH cases diagnosed by SPCT/MRI, 9 HLDH and 17 ALDH were identified by PFPCT/MRI. In 868 cases treated with PLD, the effective rate of HLDH ( n = 832), ALDH ( n = 25 ), RLDH ( n =11 ) were 825/832 (99. 2% ), 13/25, and 1/11 respectively. The effective rate of HLDH is significantly different from that of ALDH and RLDH ( x2 = 369. 69, P ＜ 0. 01 ). Conclusion PFPCT/MRI may change the grouping result of lumber disc herniation made by SPCT/MRI and can be used to objectively select patients for PLD. Key words: Intervertebral disk displacement; Lumbar vertebrae; Tomography, X-ray computed; Magnetic resonance imaging; Posture