Signal Intensity of Lumbar Disc Herniations: Correlation With Age of Herniation for Extrusion, Protrusion, and Sequestration

International Journal of Spine Surgery
Markus Rafael KoniecznyRüdiger Krauspe

Abstract

There is presently insufficient data on small groups of patients, without focus on time since herniation occurred and without establishing a valid method of measurement for signal intensity (SI) of a lumbar disc herniation (LDH) in a standard magnetic resonance imaging (MRI). SI could be reported in relation to SI of nucleus pulposus of herniated intervertebral disc, nucleus pulposus of a healthy "control" intervertebral disc, cerebral spinal fluid, or anterior anulus fibrosus. It is not known which signal intensity ratio (SIR) shows the highest correlation with time since onset of pain and how SIR of different Combined Task Forces (CTF)-types of herniation develop over time. Out of 1053 patients, we enrolled 151 patients to a retrospective single-center analysis of standard MRIs of consecutive patients treated for LDH from February 2008 to December 2017 with confirmed (surgery, injection, or electrophysiologic testing) radicular pain by LDH and known exact date of onset of pain. We excluded patients < 18 or  > 70 years, with chronical pain syndrome, spinal deformity, and history of prior spinal surgery on the affected spinal level. Because data did not show normal distribution, we assessed correlation by Spearman rank correlat...Continue Reading

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