PEDICLE MORPHOLOGY OF THE THORACOLUMBAR JUNCTION IN A TURKISH POPULATION: A PRELIMINARY STUDY
Journal Title: Journal of Turkish Spinal Surgery - Year 2004, Vol 15, Issue 3
Abstract
Introduction: The information on the herniated form of nucleus in lumbar disc hernia (HNP) is crucial to estimate the prognosis. However, conventional MRI is not always a useful strategy. We examined the patients with lumbar HNP with Fast low-angle shot (FLASH) MRI and assessed its efficacy in the form diagnosis of HNP. Subject: We studied 12 patients with HNP (31.6 y/o). There were 11 males and 1 female. Methods: MRI was performed at 1.5 Tesla. T1, T2, and FLASH images at each herniated disc were obtained. In the operated cases, they were confirmed macroscopically. Results: On FLASH, all the hernia masses were depicted obviously, and the posterior longitudinal ligaments (PLL) were observed as black line. The boundary of the hernia mass was clearer than that on T1. The images of ligamentum fIavum were also apparent. In 8 operative cases, we predicted the herniated nucleus form from the continuity of black line on FLASH and these cases were divided into transligamentous (TL) and subligamentous (SL) extrusion. These findings were identical to those obtained during the operation except for one case, in which we could not determine the form on FLASH. However, according to operation finding this case was diagnosed as the TL double-layer hernia. The results were confirmed macroscopically. In 3 with TL on FLASH of 4 non-operative cases, their symptoms were improved and the size of hernia masses was reduced. In one SL case on FLASH, the improvement was less remarkable. Discussion and Conclusion: On FLASH, the differences in signal density among tissues are remarkable. The form of the herniated nucleus was accurately determined, since the boundary between the hernia mass and PLL is more apparent than on T1. FLASH is less invasive comparing to T1, as it needs no injection of contrast media and shorter seen time. Our findings indicate that FLASH is a useful measure in the diagnosis of HNP form.
Authors and Affiliations
Abdullah MILCAN, Caner ÖZER, Volkan ÖZTUNA, Metin M. ESKANDARI, Mehmet COLAK, Fehmi KUYURTAR
Keywords
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