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Related Experiment Videos

Bulging lumbar intervertebral disk: myelographic differentiation from herniated disk with nerve root compression

S A Kieffer, R G Sherry, D E Wellenstein

    AJR. American Journal of Roentgenology
    |April 1, 1982
    PubMed
    Summary

    Differentiating bulging from herniated disks using Amipaque myelography is possible. This technique accurately identified bulging disks and 96% of herniated disks in patients with low back pain.

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    Area of Science:

    • Radiology
    • Neurosurgery
    • Orthopedics

    Background:

    • Lumbar thecal sac deformities are common in low back pain patients undergoing myelography.
    • Not all thecal sac deformities indicate herniated disks; some result from bulging disks.

    Purpose of the Study:

    • To differentiate between diffusely bulging and herniated disks using Amipaque myelography.
    • To assess the diagnostic accuracy of myelographic criteria for lumbar disk herniation.

    Main Methods:

    • Analysis of Amipaque myelography findings in 33 patients with suspected lumbar disk herniation.
    • Evaluation of extradural deformity characteristics and nerve root appearance.
    • Correlation of myelographic findings with surgical laminectomy results.

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    Main Results:

    • Bulging disks showed rounded, symmetrical deformities confined to the disk space.
    • Herniated disks presented with angular deformities extending beyond the disk space and distal nerve root widening.
    • Myelography correctly identified all six bulging disks and 96% of 27 herniated disks.

    Conclusions:

    • Specific myelographic criteria can reliably differentiate bulging from herniated lumbar disks.
    • Amipaque myelography is a valuable tool for diagnosing lumbar disk herniation, guiding surgical decisions.