Lumbar disk herniation and canal stenosis: value of intraoperative sonography in diagnosis and surgical management

AJR. American Journal of Roentgenology
B M MontalvoB A Green

Abstract

One hundred four patients with preoperative diagnoses of lumbar canal stenosis, disk herniation, or a combination of both were evaluated with intraoperative sonography with the intent of (1) describing the sonographic characteristics of herniated disks and distinguishing these from bulging anuli, epidural fat, scar tissue, and spondylolisthesis; (2) establishing criteria for adequate decompression of canal stenosis; and (3) determining the usefulness of sonography in monitoring disk removal. Disk material demonstrates medium echogenicity, different in its sonographic features from bone, epidural fat, scar tissue, and epidural veins. A sonographic diagnosis of disk herniation was made in 43 cases, 41 of which were confirmed during surgery. Sonography established the presence or absence of disk herniation (confirmed by surgery) in 14 of 19 patients who had equivocal preoperative findings. After routine diskectomy, residual disk material was found in 17 (41%) of 41 patients, which led to further surgery in 16 patients with removal of the additional disk fragments. In 84 patients undergoing decompressive surgery for canal stenosis, sonography detected residual canal compression in 19 (23%), which led to a widened decompression in 1...Continue Reading

Citations

Sep 1, 1992·Current Problems in Diagnostic Radiology·P R Luers
Jun 15, 2007·Ultrasound Quarterly·Robert A Kane, Jonathan B Kruskal
Sep 23, 2014·Journal of Korean Neurosurgical Society·Lee A TanRicardo B V Fontes

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