Value of diagnostic methods in diagnosis of the disc disease

Background. Injury of the intravertebral disc after precise clinical evaluation should be confirmed by different radiographic methods. Although diagnostic methods have recently progressed, there are still problems with proper diagnosis concerning the level of pain provocation.
The aim of this study was a comparison of clinical signs of disc prolapse with different radiographic methods and intraoperative findings.
Material and methods. 180 histories of patient treated in the Orthopaedic Clinic of Medical Centre for Postgraduate Education between 1994-2002 were analysed. The most frequent was Lasegue's sign and spine movement limitation. All patients underwent lumbar spine x-ray in order to eliminate bone pathologies of vertebrae. Before making - of operative treatment a decision of magnetic resonance imaging or computer topography were always done. Radiculography was performed only in cases of multilevel disc hernitation and when clinical signs were not obvious.
Conclusions.
1.Clinical examination and first of all different intensity of pain (over 4 degrees in VAS scale) and radiographic imaging were followed by MRI or CT in order to confirm the diagnosis.
2.CT allowed to precise a diagnosis in the case of diagnostic uncertainty among patients with long history of back pain.
3.Compatibility of x-ray (narrowing of vertebral space) with intraoperative findings was 80%. Compatibility of MRI was 96%, and computer tomography 94%.