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KMID : 0378019670100040085
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New Medical Journal
1967 Volume.10 No. 4 p.85 ~ p.95
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A Study on Plain Radiography in Herniated Lumbar Interterbral Discs
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Abstract
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It is generally considered that plain radiography of the lumbosacral region in case of suspected her-of the lumbar nucleus pulposus is essential to eliminate other pathological processes which may -give rise to similar clinical symptoms.
Although many authorities have found plain radiography has little positive value in diagnosis of herniated lumbar intervertebral disc, others have noted signs suggestive of the lesion in proportions varying from 20 to 50 per cent. of their cases.
These differences of opinion appear to have arisen because it has not generally been appreciated that intraspinal herniation of the intervertebral disc is one of the clinical manifestations in which degeneration
or trauma usually precede.
It is the purpose of this communication to evaluate the significance of the routine plain radiographical appearances resulting from herniation of the lumbar nucleus pulposus in surgically verified 435 Korean -patients.
In this series of 435 cases, routine radiographs revealed no specific abnormality in 101 cases (23,2 Per cent). Of the 101 patients whose lumbar spines appeared normal, 48 were males (16.7 per cent of all males) and 53 were females(36.5 per cent. of all females). The significance of the low incidence of deg-
tf ruerative changes in women is not clear, but is probably related with a less excessive use of the lumbar st)ine. The average age of these patients was 34 years in males and 32 years in females, and the average duration of symptoms was 1 year 8 months.
´ Diminution in the width of the intervertebral space was found in 165 instances(38 per cenr.), among which 139 cases (84.2 per cent.) were coincident with the operative findings and´the others were not. A localized scoliosis with its apax at the level of the herniation was found in 75 cases (17.1 per cent.). The convexity of the scoliosis in these cases was to the right in 18 and towards the left in 57. The lesion was found to be situated on the same side or contralateral side as to the convexity of the curve.
A localized kyphosis with its apex at the level of the herniation was found in 11 cases(2.5 per cent.). Hypertrophic changes localized to the margins of contiguous vertebral bodies could be demonstrated at the level of the herniation in 48 cases (I1 per cent.).
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