Diagnosis of extreme lateral lumbar disc herniation with spiral CT multiplanar reformation / 中华放射学杂志

ABSTRACT

Objective To investigate the characteristics of extreme lateral lumbar disc herniation (ELLDH) with spiral CT multiplanar reformation (MPR), and to determine the effectiveness of MPR in the diagnosis of ELLDH. Method Twenty-five cases with ELLDH underwent conventional CT scans, thin slice spiral scan, and MPR on coronal and sagittal plane. Results Operative findings basically matched the MPR results in 25 ELLDH patients concerning the disc herniation position and compression of the nerve roots. The herniation involved the intervertebral foramina in 15 cases, external intervertebral foramina in 4, both intervertebral and external intervertebral foramina in 3, and intervertebral foramina and vertebral tubes of parity plane in 3. They were demonstrated on MPR as shapes of hillock, circular or trigonal soft-tissue density mass in intervertebral foramen, or outside and tread on the nerve root of parity plane. Among these 25 ELLDH cases, ELLDH was not found by conventional CT scans in 7 cases, but was found by MPR. ELLDH was suspected by conventional CT in 8, and was confirmed to be ELLDH by MPR. ELLDH was revealed by conventional CT scans in 10, but without indications of nerve root compression status, while MPR clearly indicated nerve root compression status. Conclusion MPR has important value in the diagnosis of ELLDH. It can properly identify the ELLDH site, shape, size, and its relation to nerve roots. It is very helpful for the surgeons in the selection of operation method.