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Overreporting of the disc herniation in lumbar spine MRI scans performed for patients with spondylolisthesis
Hassan Semaan1, Bryan Curnutte2, Maxwell Cooper2
1Department of Radiology, University of Toledo Medical Center, Toledo, OH, USA.
Background:
Spondylolisthesis is often misdiagnosed on magnetic resonance imaging (MRI) as the slip may reduce to a normal alignment when the patient lies supine. Often, disc herniation is reported at the level of spondylolisthesis.
Purpose:
To determine the incidence rates of disc herniation at the level of spondylolisthesis.
Material And Methods:
This is a retrospective study included 258 consecutive patients with spondylolisthesis who had lumbar spine MRI. The archived reports were collectively put in Group 1. A musculoskeletal radiologist and a spine surgeon reviewed the imaging studies together. Their readings were referred to as Group 2. The findings of both groups were compared to evaluate whether disc herniation was overreported.
Results:
Group 1 reported findings of true disc herniation in 112 (41.6%) cases and pseudo disc herniation or no findings of disc herniation at the level of spondylolisthesis in 157 (58.4%) cases. Group 2 reported findings of a true disc herniation in 25 (9.3%) cases and pseudo disc herniation or no findings of disc herniation in the remaining 244 (90.7%) cases. There was a statistically significant difference in the reporting rates between these two groups (P < 0.02). The most overreported finding was the disc bulging (P < 0.01).
Conclusion:
The current study showed overreporting of disc herniation in lumbar spine MRI scans performed for patients with established spondylolisthesis. The majority of disc pathology at the level of spondylolisthesis are pseudo disc rather than a true disc herniation. An accurate diagnosis is vital in planning surgical intervention.
Insights
Spondylolisthesis MRI scans frequently misdiagnose disc herniation. Most disc issues at this level are pseudo-herniations, not true herniations, impacting surgical planning.
Area of Science:
- Radiology
- Spine Surgery
- Diagnostic Imaging
Background:
- Spondylolisthesis on MRI can be misdiagnosed due to supine positioning reducing slip.
- Disc herniation is often incorrectly reported at the spondylolisthesis level.
Purpose of the Study:
- To determine the incidence rates of disc herniation at the level of spondylolisthesis.
- To evaluate the overreporting of disc herniation in spondylolisthesis cases.
Main Methods:
- Retrospective analysis of 258 patients with spondylolisthesis undergoing lumbar spine MRI.
- Comparison of initial archived MRI reports (Group 1) with a secondary review by a radiologist and spine surgeon (Group 2).
Main Results:
- Group 1 reported true disc herniation in 41.6% of cases; Group 2 reported true disc herniation in only 9.3%.
- A statistically significant difference in reporting rates was observed between the groups (P < 0.02).
- Disc bulging was the most frequently overreported finding (P < 0.01).
Conclusions:
- Lumbar spine MRI for spondylolisthesis overreports disc herniation.
- The majority of disc pathology in spondylolisthesis is pseudo-disc herniation, not true herniation.
- Accurate diagnosis is crucial for effective surgical planning.
