Computed tomographic, myelographic, and operative findings in patients with suspected herniated lumbar discs.
Fifty patients presenting with a suspected herniated lumbar intervertebral disc were evaluated with sector computed tomography (CT). Excluded from this series were patients with prior lumbar laminectomy or a clinical diagnosis of lumbar canal stenosis. Forty-six of the patients also underwent preoperative lumbar myelography. All patients subsequently underwent laminectomy. In 40 patients (80%), CT was positive. In the remaining 10 patients (20%), it was negative; in this group the myelogram correctly predicted the lesion in 8 (80%). Sector CT correctly predicted the nature of the lesion in 24 patients (48%), was incorrect in 14 (28%), and gave incomplete findings in 12 (24%). CT was most accurate when it demonstrated a disc protrusion as the only finding. In this group, sector CT correctly predicted the operative findings in 24 of 25 patients (96%). CT was less accurate when spondylitic compression was diagnosed. This study suggests that sector CT is a useful test in the evaluation of patients with sciatica and that, when a soft herniated disc is demonstrated on CT, myelography may be omitted.
D000328:Adult; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009192:Myelography; D012585:Sciatica / Q000150:complications; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging; D013126:Spinal Nerve Roots; D013128:Spinal Osteophytosis / Q000000981:diagnostic imaging; D013166:Spondylitis / Q000150:complications; D014057:Tomography, X-Ray Computed