Features of Clinical and Magnetic Resonance Imaging of Lumbar Disc Herniation

A study of 55 patients with lumbar disc herniation who were taken MRI and surgery at hospital E from January 2019 to December 2019. Results: The mean age was 58.96 ± 16.4, the female/male ratio was 1.12/1. People doing heavy work had a higher risk of disc herniation than those doing light work (63.7%). Common symptoms: lumbar pain (100%), sciatica pain, pain with mechanical properties (85.45%), limited spinal movement (90.91%), Lasègue sign (+) (74.55%), bell sign (+) (54.55%); signs of nerve root damage: sensory disturbances 72.73%, movement disorders 50.91%. Clinical lesions were common in L5 (65.45%) and S1 (45.45%) roots. Hernias were common at L4/5 (81.8%) and L5/S1 (70.9%). The degree of hernia was mainly bulge and hernia, accounting for 60% and 52.73%, respectively. 98.18% herniated to the back, central hernia accounted for the highest rate (41.82%). The rate of nerve root compression detected on MR is 90.91%. Evaluation of nerve root damage in clinical and magnetic resonance had high concordance in L5 and S1 roots (98.17% and 100%, respectively). Conclusion: MRI helps in early, accurate diagnosis and treatment orientation of lumbar disc herniation. Keywords: Disc herniation, MRI lumbar spine, lumbar pain.  References [1] R. J. Gardocki, A. L. Park, Lower Back Pain and Disorders of Intervertebral Discs, Campbell's Operative Orthopaedics, 12th ed, Elsevier Mosby, 2013:chap 42.[2] N. V. Chuong et al., Research on Lumbar Disc Herniation at Department - Department of Internal Neurology, Hospital 103 - Military Medical Academy, Journal of Military Medicine, Vol. 3, 2015, pp. 5 - 16 (in Vietnamese).[3] S. Lee, J. H. Kang, U. Srikantha et al., Extral Foraminal Compression of the L5 Nerve Root at the Lumbosacral Junction: Clinical Analysis, Decompression Technique, and Outcome, Journal Neurosurgery Spine, Vol. 24, No. 1, 2014, pp. 1-9, https://doi.org/10.3171/2013.12.spine12629.[4] S. Eicker, S. Rhee, H. Steiger et al., Transtubular Microsurgical Approach to Treating Extra Foraminal Lumbar Disc Herniations, Neurosurgery Focus, Vol. 35, No. 2E1, 2013, pp. 1-6, https://doi.org/10.3171/2013.4.focus13126. [5] H. M. Cuong, Research on the Diagnosis and Surgical Treatment of Disc Herniation in the Lumbar Spine and Side Deviation by Bone Window Opening Method, Master's Thesis of Medicine, Hanoi Medical University, 2010 (in Vietnamese).[6] J. D. Lurie, T. D. Tosteson, A. N. Tostenson et al., Surgical Versus Non-operative Treatment for Lumbar Disc Herniation: Eight-year Results for the Spine Patient Outcomes Research Trial, Spine, Vol. 39, No. 1, 2014, pp. 3-16, https://dx.doi.org/10.1097%2FBRS.0000000000000088.[7] M. R. Konieczny, R. Jeremia, M. Post et al., Signal Intensity of Lumbar Disc Herniations: Correlation With Age of Herniation for Extrusion, Protrusion, and Sequestration, Int J Spine Surg. Vol. 14, No. 1, 2020, pp. 102–107, https://doi.org/10.14444/7014.[8] M. H. Daghighi, M. Pouriesa, M. Maleki et al., Migration Patterns of Herniated Disc Fragments: a Study on 1,020 Patients with Extruded Lumbar Disc Herniation, Spine Journal, Vol. 14, No. 9, 2014, pp. 1970-1977, https://doi.org/10.1016/j.spinee.2013.11.056.[9] M. Karademir, O. Eser, E. Karavelioglu, Adolescent Lumbar Disc Herniation: Impact, Diagnosis, and Treatment, J. Back Musculoskelet Rehabil, Vol 30, No. 2, 2017, pp. 347-352, https://doi.org/10.3233/bmr-160572.[10] R. G. Menon, M. V. W. Zibetti, M. Pendola et al., Measurement of Three-Dimensional Internal Dynamic Strains in the Intervertebral Disc of the Lumbar Spine with Mechanical Loading and Golden-Angle Radial Sparse Parallel-Magnetic Resonance Imaging, J Magn Reson Imaging, Vol. 54, No. 2, 2021, pp. 486–496, https://doi.org/10.1002/jmri.27591.