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Related Experiment Videos

Computed tomographic appearance of the bulging annulus

A L Williams, V M Haughton, G A Meyer

    Radiology
    |February 1, 1982
    PubMed
    Summary

    Computed tomography (CT) can now differentiate bulging annulus fibrosus from herniated nucleus pulposus. Bulging annulus shows generalized disk extension, while herniation presents as a focal protrusion on CT scans.

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    Area of Science:

    • Radiology
    • Orthopedic Surgery
    • Medical Imaging

    Background:

    • Differentiating between herniated nucleus pulposus and bulging annulus fibrosus using computed tomography (CT) lacks established criteria.
    • Accurate diagnosis is crucial for appropriate treatment of lumbar disc disorders.
    • Computed tomography is a primary imaging modality for evaluating spinal conditions.

    Purpose of the Study:

    • To establish CT criteria for distinguishing bulging annulus fibrosus from herniated nucleus pulposus.
    • To evaluate the diagnostic accuracy of CT in identifying bulging annulus fibrosus.

    Main Methods:

    • Correlation of CT findings with anatomic appearance in cadaver lumbar spines.
    • Comparison of CT findings with surgical outcomes in patients undergoing lumbar laminectomy.
    • Analysis of disk margin characteristics on CT scans.

    Main Results:

    • Computed tomography demonstrated generalized extension of the disk margin beyond vertebral body margins in cases of anatomically or surgically verified bulging annulus fibrosus.
    • Herniated nucleus pulposus was characterized by a focal, typically posterolateral, protrusion of the disk margin on CT.
    • These CT findings allowed for differentiation between the two conditions.

    Conclusions:

    • Computed tomography can reliably distinguish between bulging annulus fibrosus and herniated nucleus pulposus.
    • Generalized disk margin extension on CT indicates a bulging annulus fibrosus.
    • Focal disk protrusion on CT suggests herniated nucleus pulposus, guiding clinical management.

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