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Updated: Jun 16, 2026
Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Prediction of successful discectomy using MRI quantitation of dural sac and herniated disc dimensions
S G Pneumaticos1, A N Chatziioannou, J Hipp
1Department of Orthopaedic Surgery, University of Athens Medical School, Athens, Greece and Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA.
Objective:
To evaluate the ability of magnetic resonance imaging (MRI) quantitation of disc prolapse and dural sac to identify those who would benefit from discectomy.
Methods:
Thirty consecutive patients with disc herniation and leg pain who had MRI of lumbar spine and subsequently underwent discectomy were prospectively enrolled and compared with 30 controls. The anteroposterior (AP) diameter and the cross-sectional area of disc prolapse and of dural sac were measured. The ratios of AP diameters and cross-sectional areas were calculated. The measurements were correlated with the relief of symptoms based on a visual analogue scale assessment preoperatively and 1 week postoperatively.
Results:
All patients preoperatively had a pain score of seven or higher (mean +/- SD = 7.9 +/- 0.3) and postoperatively a score of < or = 2(mean +/- SD = 1.1 +/- 0.2). The AP diameter of disc prolapse and the ratio of AP diameters demonstrated the highest sensitivity and specificity: an AP diameter of 3.3 mm was 99% sensitive and specific and a ratio of the AP diameters of 0.37 was 100% sensitive and 99% specific.
Conclusion:
Quantitative measurements of MRI can improve significantly the ability to identify the patients who would benefit from discectomy.
