[Diagnostic recognition of nucleus pulposus prolapse in light of clinical and radiologic correlations]

The authors compared the agreement between clinical, radiological and surgical diagnoses in 33 cases of nucleus pulposus prolapse. A complete agreement of diagnoses was obtained in 88% of cases. The mechanism and incidence of different signs and their importance for the diagnosis of nucleus pulposus prolapse are discussed. It should be stressed that the compression of nerve roots recognized on radiculography is not pathognomonic sign of prolapse and may be due to such processes as development of marginal osteophytes in the degenerative disc disease, thickening of the posterior longitudinal ligament, hypertrophy of radicular processes or necks of vertebral arches. In the light of own experiences and data from the literature the authors consider radiculography with Amipaque and computer tomography as the method of choice in cases with suspected disc herniation in the lumbar region.