correlation between magnetic resonance imaging and the operative and clinical findings after lumbar discectomy

ABSTRACT

Forty two patient were admitted to Mansoura University Hospital for treatment of lumbar disc prolapse. They were studied prospectively with magnetic resonance imaging before they had open discectomy, and the findings were correlated with clinical symptoms before and after operation and with the operative findings. There were 26 males and 16 females. The patients aged between 25 and 60 years with an average of 37.5 years. MRI studies showed, a sequestrated fragment in 59% of patients, a subligamentous disc sequestration in 25% and a disc protrusion in 16%. In twenty five patients the operated level was [L4-L5], while in 16 patients the operated level was [L5-S1], and only in one patient, the operated level was L3-L4. The diameter of the protrusion was 4 mm to 13 mm for the craniocaudal extension, and 5 mm to 18 mm for the anteroposterior extension. No correlation could be found between the neurological deficit and the size of the disc prolapse. There was significant correlation between obstruction of the spinal canal and the type of the disc lesion, either extrusion, subligamentous disc sequestration, and free sequestration. Magnetic resonance imaging is a helpful pre-operative diagnostic investigation which shows structural changes in the disc and the correct localisation and size of the disc sequestration, but there was no correlation between the imaging findings and the clinical symptoms