Comprehensive clinical assessment on imaging diagnosis of low back pain
- VernacularTitle:下腰痛影像诊断的临床综合评估
- Author:
Youzhuan XIE
;
Xiaokui HOU
;
Zhenan ZHU
- Publication Type:Journal Article
- Keywords:
low back pain;
conventional roentgenogram;
myelography;
CT;
MRI
- From:
Orthopedic Journal of China
2006;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To pursue the appropriate selection of radiographic examinations of low back pain and to reduce the expenses. Method In this study,61 cases of imaging tests were studied,including 38 cases of lumbar disc herniation,10 cases of lumbar spondylolisthesis,4 lumbar stenosis,4 lumbar infection and 5 lumbar neoplasm. Result Correct diagnosis was based on the clinical signs and symptoms.Imaging findings had its value only when basing on them.Conventional roentgenogram offered a cheap evaluation and high spatial resolution of bony structures.And it could give a clue to take further imaging studies.Low back disorders could be inferred from the contrast column defect of dura sac and nerve root sheath in the myelography.In the diagnosis of disc herniation,its limitations existed at far lacteral and L5S1 disc herniation.Computed tomography,a cross-sectional imaging modality,allows direct visualization of the bony structure of the spine.But routine imaging could only cover a limited number of levers.Another limitation was the difficulty in distinguishing the soft tissue changes in the spinal canal with the similar CT values.CT-myelography was performed to delineate more clearly the bony and soft tissue anatomy,and could determine whether lesions were medullary,intradual or extradual in location.MR imaging provided the larger anatomic region in multiple planes with high spatial resolution of soft tissue.One limitation of MR imaging was relatively low spatial resolution of bony structure. Conclusion Of all imaging studies conventional roentgenogram is the most important and the most fundamental.It could not be substituted by myelography,CT,CT-myelography,and MR imaging,which have their designated own roles respectively in the clinical decision-making process and in general were more complementary than competitive.
