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Lumbar disk herniation: correlation of histologic findings with marrow signal intensity changes in vertebral

Gebhard Schmid1, Andreas Witteler, Roland Willburger

  • 1Department of Radiology and Nuclear Medicine, St Josef Hospital, Ruhr-Universität Bochum, Gudrunstrasse 56, 44791 Bochum, Germany. gebhard.schmid@ruhr-uni-bochum.de

Radiology
|April 6, 2004
PubMed
Abstract

Insights

Magnetic resonance (MR) imaging showing vertebral endplate changes can indicate cartilaginous material in herniated disc material. This finding is common in avulsion-type disc herniations, aiding surgical planning.

Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Spine Surgery

Background:

  • Lumbar disc herniation is a common condition requiring surgical intervention.
  • Accurate preoperative assessment of herniated disc material composition is crucial for surgical planning and predicting outcomes.

Purpose of the Study:

  • To correlate preoperative magnetic resonance (MR) imaging findings with the tissue composition of herniated disc material.
  • To investigate the relationship between vertebral endplate changes and the presence of cartilaginous material in extruded disc fragments.

Main Methods:

  • Fifty-one patients with lumbar disc herniation underwent preoperative MR imaging.
  • Marrow signal intensity changes (Modic types 1-3) and endplate defect severity were assessed.
  • Tissue composition of surgically removed herniated material was analyzed.

Main Results:

  • Mean herniated material composition was 63% anulus fibrosus, 30% nucleus pulposus, and 8% cartilaginous endplate.
  • Patients with vertebral endplate marrow signal intensity changes had significantly more cartilaginous material in their herniated discs (P=.023).
  • Vertebral corner defects were associated with a higher prevalence of endplate cartilage in extruded material (82% vs. 40%, P=.019).

Conclusions:

  • Vertebral endplate marrow signal intensity changes on MR imaging are indicative of cartilaginous material in herniated disc fragments.
  • Avulsion-type disc herniations, characterized by endplate involvement, appear to be common.
  • MR imaging findings can help predict the presence of cartilage in herniated disc material, potentially influencing surgical approaches.

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