[Value of imaging techniques in the diagnosis of lumbar intervertebral disk prolapse]

As a seeming law of nature the possibility of making use of various multiplanar sectional imaging techniques is accompanied by diagnostic exaggeration. Simple and cost effective procedures with low radiation dosage such as plain x-rays of the spine are being thrust into the background. Not seldom are patients referred to the spine surgeon with MRI or Cat scan at hand but lacking standard radiographs. As far as the assessment of intervertebral disc disease is concerned the combination of plain X-rays of the spine and computed tomography of the level in question turned out to be sufficient for indication of the operation in more than 90% of 450 patients after nucleotomie at the Orthopedic University Clinic Mainz. To our mind MRI should be restricted to cases in whom disc surgery had failed to relieve sciatica. Here it allows to distinguish between a recurrent HNP and postoperative scar tissue. In our patients myelography, an invasive procedure, has its role only in emergency diagnostics, and in the dynamic-functional examination.