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  • New Diagnostic Tool for Far Lateral Lumbar Disc Herniation : The Clinical Usefulness of 3-Tesla Magnetic Resonance Myelography Comparing with the Discography CT

    Final Number:

    Jong-Pil Eun MD. PhD; Young-Min Oh MD, PhD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Recently, physicians have used magnetic resonance imaging (MRI) to diagnosis lumbar degenerative disease. However, the accurate diagnosis of far lateral lumbar disc herniation is often difficult. At present, one of the most effective diagnostic tool for far lateral disc herniation is disco-enhanced computed tomography (disco-CT). Although only this examination could differentiate disc herniation from other pathological conditions responsible for extreme lateral nerve root entrapment, it is an invasive method. And disc injection sometimes reproduced a patient's clinical pain patterns, physicians have hesitated to use this assessment because of its invasiveness. With the above in mind, we aimed to demonstrate how 3-tesla magnetic resonance myelography (3T-MRM) compared to disco-CT could be a useful method for diagnosing far lateral lumbar disc herniation.

    Methods: We evaluated 3T MRM and disco-CT of 25 patients, whom we suspected of suffering from far lateral disc herniation. Using an assessment scale, 4 observers examined independently both 3T MRM and disco-CT images. We analyzed observer agreement and the accentuation of each image.

    Results: We found complete matching, and observer agreement, between high resolution images of 3T MRM and disco-CT for diagnosing far lateral disc herniation.

    Conclusions: We think noninvasive 3T MRM is an appropriate diagnostic tool for far lateral disc herniation as compared to disco-CT.

    Patient Care: Using this diagnostic tool (3T MRM), we can make it easy to diagnose the far lateral lumbar disc herniation without confirmation with invasive disco-CT.

    Learning Objectives: To prospectively assess the diagnostic and clinical value of a new technique 3T MRM) as compared to disco-CT in patients with far lateral disc herniation.

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