title: Three-dimensional radiological classification of lumbar disc herniation in relation to surgical outcome.
abstract: Centrally located lumbar disc herniations have been reported to be of predictive value for poor post-operative clinical outcome. One hundred and fifty patients undergoing lumbar disc herniation surgery were prospectively included. Herniation-related parameters, including the grading of contours, were assessed from pre-operative computed tomography (CT) and magnetic resonance imaging (MRI) images using a new three-dimensional grading system. The radiological findings were compared with outcome parameters two years post-operatively (patient-assessed pain, function/health scores and evaluation by an independent observer). An intra- and inter-observer validation of the classification was performed in a subgroup of patients. High intra-observer and good inter-observer reliability for both CT and MRI was seen. In the study population, no relation between the distribution or size of the herniations and outcome at 2-year follow-up were found. The distribution and size of the lumbar disc herniations with the three-dimensional classification were not found to be of importance for the clinical outcome.
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden. klas.halldin@vgregion.se
authors.forename: K
authors.initials: K
authors.lastname: Halldin
authors.forename: B
authors.initials: B
authors.lastname: Lind
authors.forename: K
authors.initials: K
authors.lastname: Rönnberg
authors.forename: J
authors.initials: J
authors.lastname: Göthlin
authors.forename: G
authors.initials: G
authors.lastname: Gadeholt-Göthlin
authors.forename: B
authors.initials: B
authors.lastname: Zoëga
authors.forename: H
authors.initials: H
authors.lastname: Brisby
mesh_terms: D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology; D004185:Disability Evaluation; D017586:Diskectomy; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D015588:Observer Variation; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D011183:Postoperative Complications; D011300:Preoperative Care; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome