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Herniated intervertebral disc without pain

W F Gorman1, J A Hodak

  • 1Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

The Journal of the Oklahoma State Medical Association
|May 1, 1997
PubMed
Summary
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Radiologic imaging often shows herniated intervertebral disc signs in healthy individuals without back pain. Relying solely on imaging can lead to misdiagnosis of herniated discs.

Area of Science:

  • Radiology
  • Orthopedics
  • Neurosurgery

Background:

  • Herniated intervertebral discs commonly cause radicular pain (sciatica, brachialgia) and low back/neck pain.
  • Radiologic imaging (X-ray, CT, MRI, myelogram) is frequently used to confirm herniated disc diagnoses.
  • Radiologic findings for herniated discs include bulge, protrusion, prolapse, extension, extrusion, and sequestration.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of radiologic imaging for herniated intervertebral discs.
  • To determine the prevalence of radiologic herniated disc signs in asymptomatic individuals.

Main Methods:

  • Literature review defining herniated disc radiologic terms.
  • Analysis of radiologic studies on asymptomatic control groups without prior radicular pain or low back/neck pain.

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Main Results:

  • Various radiologic signs indicative of herniated intervertebral discs were observed in over 25% of asymptomatic controls.
  • These findings were consistent across plain X-ray, CT scans, myelograms, and MRI.

Conclusions:

  • Radiologic imaging findings alone are insufficient for definitively diagnosing herniated intervertebral discs.
  • Clinical correlation is essential, as imaging may reveal asymptomatic disc abnormalities.