Kyoung Hyup Nam1, In Sook Lee2, You Seon Song3, In Ho Han1, Dong Hwan Kim1. 1. Pusan National University School of Medicine, Busan, Republic of Korea; Department of Neurosurgery, Pusan National University Hospital, Biomedical Research Institute, Busan, Republic of Korea. 2. Pusan National University School of Medicine, Busan, Republic of Korea; Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Busan, Republic of Korea. Electronic address: lis@pusan.ac.kr. 3. Pusan National University School of Medicine, Busan, Republic of Korea; Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Busan, Republic of Korea.
Abstract
OBJECTIVE: To compare the computed tomography (CT) and magnetic resonance imaging (MRI) findings of lumbar intradural disc herniation (IDH) and disc extrusion mimicking IDH. MATERIALS AND METHODS: Between January 2015 and August 2018, 32 with surgically confirmed IDH or disc extrusion mimicking IDH were included. Age, sex, symptoms, herniated disc level, history of discectomy at the same site, and operative findings were investigated through the medical records. We evaluated the direction, type, migration, margin, and shape of disc herniation, the presence of an abrupt discontinuity of the posterior longitudinal ligament (PLL), Y-sign of ventral dura, disc material beyond the PLL, and disc calcification or ossification. In addition, maximum herniated disc diameter to central canal diameter (MHDD/CCD) ratios were calculated. RESULTS: Twelve patients (8 males, 4 females; mean age 53.3 [21-83] years) were surgically confirmed to have lumbar IDH and 20 (11 males, 9 females; mean age 52 [19-78] years) had disc extrusion mimicking lumbar IDH. Margins and beak-like shapes of herniated discs, abrupt discontinuity of the PLL, Y-sign of ventral dura, disc material beyond the PLL, calcification or ossification of herniated discs, and MHDD/CCD ratios were significantly different in the IDH and non-IDH groups (p < 0.05). CONCLUSION: Imaging findings of an ill-defined margin, a beak-like shape, herniated disc calcification or ossification, abrupt PLL discontinuity, Y-sign of ventral dura, disc material beyond the PLL and a high MHDD/CCD ratio were found to predict the presence of IDH.
OBJECTIVE: To compare the computed tomography (CT) and magnetic resonance imaging (MRI) findings of lumbar intradural disc herniation (IDH) and disc extrusion mimicking IDH. MATERIALS AND METHODS: Between January 2015 and August 2018, 32 with surgically confirmed IDH or disc extrusion mimicking IDH were included. Age, sex, symptoms, herniated disc level, history of discectomy at the same site, and operative findings were investigated through the medical records. We evaluated the direction, type, migration, margin, and shape of disc herniation, the presence of an abrupt discontinuity of the posterior longitudinal ligament (PLL), Y-sign of ventral dura, disc material beyond the PLL, and disc calcification or ossification. In addition, maximum herniated disc diameter to central canal diameter (MHDD/CCD) ratios were calculated. RESULTS: Twelve patients (8 males, 4 females; mean age 53.3 [21-83] years) were surgically confirmed to have lumbar IDH and 20 (11 males, 9 females; mean age 52 [19-78] years) had disc extrusion mimicking lumbar IDH. Margins and beak-like shapes of herniated discs, abrupt discontinuity of the PLL, Y-sign of ventral dura, disc material beyond the PLL, calcification or ossification of herniated discs, and MHDD/CCD ratios were significantly different in the IDH and non-IDH groups (p < 0.05). CONCLUSION: Imaging findings of an ill-defined margin, a beak-like shape, herniated disc calcification or ossification, abrupt PLL discontinuity, Y-sign of ventral dura, disc material beyond the PLL and a high MHDD/CCD ratio were found to predict the presence of IDH.
Authors: Phattareeya Pholprajug; Tada Wiratapesuporn; Kantang Satayasoontorn; Surapon Atiprayoon; Vit Kotheeranurak Journal: N Am Spine Soc J Date: 2022-06-18
Authors: David Casado; Ricardo Fernandes; Filipa Lourinho; Rita Gonçalves; Robert Clark; Francesca Violini; Inés Carrera Journal: Front Vet Sci Date: 2022-09-14