Role of weight-bearing flexion and extension myelography in evaluating the intervertebral disc.
Magnetic resonance imaging has many advantages compared with myelography and/or computed tomography in evaluating the lumbar spine for herniated nucleus pulposus. The authors have included a series of three patients whose histories and physical examinations were clinically suggestive of herniated nucleus pulposus but whose magnetic resonance imaging scans were interpreted by a radiologist as a disc bulge without nerve root compression. Because all patients had not responded to a conservative care treatment program and surgical intervention was to be considered, subsequent testing with lumbar myelography with weight-bearing flexion and extension views demonstrated more clearly the presence of herniated nucleus pulposus along with compression of the nerve root; it also revealed that a positional change in the disc occurred with flexion and extension.
Botwin
K P
KP
Florida Spine Institute, Clearwater 33765, USA.
Skene
G
G
Tourres-Ramos
F M
FM
Gruber
R D
RD
Bouchlas
C G
CG
Shah
C P
CP
D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods*; D011843:Radiculopathy / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing