Lal Rehman, Samina Khaleeq, Abid Hussain, Ehtesham Ghani, Mushtaq, Khaleequz Zaman.
Correlation between clinical features and Magnetic Resonance Imaging findings in patients with lumbar disc herniation
J Postgrad Med Inst Jan - Mar 2007;21(1):65-70.
Pakistan Institute of Medical Sciences, Islamabad
Objective: To find out the correlation of clinical features and magnetic resonance imaging (MRI) findings in determining the level of lumbar disc herniation. Material and Methods: It was an analytic study, which was conducted in the department of Neurosurgery Institute of Medical Sciences (PIMS), Islamabad, from 1st May 2002 to 1st March 2003. The total number of patients with prolapsed intervertebral disc, selected for this study was fifty. The clinical level of disc herniation was determined and was correlated with MRI findings. For data analysis, SPSS 10 soft ware was used. Results: In 29 (58%) patients there was right sciatica, while eighteen (36%) had bilateral sciatica. Straight leg raising test was positive in 47 (94%) patients. On MRI, 48 (96%) cases had prolapsed intervertebral discs (PIVD) at L4-L5 and L5-S1 levels and 2 (4%) patients had L3-4 disc herniation. Thirty-eight patients had posterolateral disc herniation and 12 patients had central disc herniation. At L4-L5 level, the sensitivity, specificity, positive predictive value and negative predictive value of all clinical features was 92%, 96%, 95.8% and 88.46% respectively. The chi square value for L4-L5 and L5-S1 was 38.78 (P=0.000) and 22.12 (P=0.000) respectively, while for multiple level disc herniation, it was 3.42 (P=0.064). Conclusion: Majority of PIVD lie in lower lumbar region. There is excellent correlation between the clinical features and MRI findings in the diagnosis of single level disc herniation but no correlation occurs in case of multiple level disc herniations.
Category: Neurosurgery
Keywords: Intervertebral Disc. Disc Herniation. Vertebral Column. MRI.
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