Previous Next

ARCHIVE

№4' 2020

RADIATION DIAGNOSIS

International Medical Journal, Vol. 26., Iss. 4, 2020, P. 83−88.


DOI (https://doi.org/10.37436/2308-5274-2020-4-15)

ROLE OF ULTRASONOGRAPHY IN DIAGNOSIS OF SPINAL STENOSIS WITH LUMBAR OSTEOCHONDROSIS


Abdullaiev R. Ya.

Kharkiv Medical Academy of Postgraduate Education, Ukraine

Diagnostic visual examinations for patients with any type of spinal stenosis include either magnetic resonance imaging or computed tomography with myelogram, sometimes both tests are prescribed to patients. Ultrasound is usually most effective for tissues with a high content of collagen, i.e. tendons, ligaments, joint capsules and fascia. In osteochondrosis, spinal ultrasonography is used to determine whether a back pain is the result of cracks or a herniated disc. To evaluate the possibilities of ultrasound in diagnosis of lumbar spine stenosis, an analysis of its results in 48 patients aged 41−57 years. Forty five of them were diagnosed with intervertebral disc herniation, 3 with protrusion of various localization and hypertrophy of the yellow ligament. All the patients underwent radiography, magnetic resonance or computed tomography, as well as ultrasound. In 24 patients the laminectomy was performed in 31 discs. In 21 cases, the hernia was paramedian, in 17 it was − median and in 14 this was circular. Laminectomies were performed much more frequently due to median and circular hernias. The slightest deformation of spinal canal is observed in the posterolateral localization of hernia or protrusion. In thin individuals, ultrasound images of the spinal canal elements were excellent, in those with moderate weight they were slightly inferior to magnetic resonance imaging. In three cases of spinal canal stenosis in obese patients who underwent laminectomy, the results of ultrasonography were unsatisfactory and the decision for surgery was made only on the basis of magnetic resonance imaging. It is concluded that ultrasound is a very informative way of assessing the degree of lumbar spine stenosis resulted from degenerative changes in intervertebral discs.

Key words: ultrasonography, spinal canal stenosis, lumbar osteochondrosis, lumbar intervertebral discs.


REFERENCES


1. Ulrich P. F. Lumbar Spinal Stenosis: A Definitive Guide. Orthopedic Surgeon (retured). Updated: 05/10/2011.

2. Shim J. H. Spinal Stenosis Symptoms and Diagnosis. Updated: 09/04/2015.

3. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology / D. F. Fardon et al. // Spine J. 2014. Vol. 1, № 14 (11). R. 2525−2545. doi: 10.1016/j.spinee.2014.04.022

4. Cousins J. P., Haughton V. M. Magnetic resonance imaging of the spine // J. Am. Acad. Orthop. Surg. 2009. № 17 (1). R. 22−30. PMID 19136424.

5. Sheehan N. J. Magnetic resonance imaging for low back pain: indications and limitations // Postgrad. Med. J. 2010. № 86 (1016). R. 374−378.

6. Lumbar Spine: Agreement in the Interpretation of 1.5−T MR Images by Using the Nordic Modic Consensus Group Classifi Sation Form / A. E. Estanislao et al. // Radiology. 2010. Vol. 254, № 3. P. 809−817. doi: https://doi.org/10.1148/radiol.09090706

7. Lumbar spine: reliability of MR imaging findings / J. A. Carrino et al. // Radiology. 2009. Vol. 250 (1). P. 161−170.

8. Agreement in the interpretation of magnetic resonance images of the lumbar spine / F. M. Kovacs et al. // Acta Radiol. 2009. Vol. 50 (5). P. 497−506.

9. Reliability of readings of magnetic resonance imaging features of lumbar spinal stenosis / J. D. Lurie et al. // Spine (Phila Pa 1976). 2008. Vol. 33 (14). P. 1605−1610. doi: https://doi.org/10.1097/brs.0b013e3181791af3

10. Magnetic resonance imaging interpretation in patients with symptomatic lumbar spine disc herniations: comparison of clinician and radiologist readings / J. D. Lurie et al. // Spine (Phila Pa 1976). 2009. Vol. 34 (7). P. 701−705. doi: https://doi.org/10.1097/brs.0b013e31819b390e

11. NASS Practice Guidelines. Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis (Revised 2011). URL: https://www.spine.org/Documents/ResearchClinicalCare/Guidelines/LumbarStenosis.pdf

12. Ogikubo O., Forsberg L., Hansson T. The relationship between the cross−sectional area of the cauda equina and the preoperative symptoms in central lumbar spinal stenosis. Spine. 2007. Vol. 32 (13). P. 1423−1428. doi: https://doi.org/10.1097/brs.0b013e318060a5f5

13. Gilbert T. J., Mullin W. J., Pobiel R. S. Lumbar Spine Definitions and Diagnostic Criteria: Degeneration, Herniation and Stenosis. April 1, 2015 revision.

14. Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images / C. Schiza et al. // Spine. 2010. Vol. 35. P. 1919−1924. doi: https://doi.org/10.1097/brs.0b013e3181d359bd

15. MRI evaluation of lumbar spinal stenosis: Is a rapid visual assessment as good as area measurement? / G. Lonne et al. // Eur. Spine J. 2014. Vol. 23 (6). P. 1320−1324. doi: https://doi.org/10.1007/s00586−014−3248−4

16. A practical MRI grading system for lumbar foraminal stenosis / S. Lee et al. // AJR. 2010. Vol. 194. P. 1095−1098.

17. A new grading system of lumbar central canal stenosis on MRI: an easy and reliable method / G. Y. Lee et al. // Skeletal. Radiol. 2011. Vol. 40. P. 1033−1039. doi: https://doi.org/10.1007/s00256−011−1102−x

18. Clinical correlation of a New Imaging Method for Assessing Lumbar Foraminal Stenosis / H. J. Park et al. // AJNR. 2012. Vol. 33. P. 818−822.

19. Abdullaev R. Ya., Ponomarenko S. A. The method of diagnosis of the lumbar spine stenosis. Patent of Ukraine. № 11966, January 16, 2006, Bul. № 1, 2006.

20. Smith J., Finnoff J. T. Diagnostic and interventional musculoskeletal ultrasound: Part 1. Fundamentals // Physical Medicine & Rehabilitation. 2009. Vol. 1 (1). P. 64−75. doi: https://doi.org/10.1016/j.pmrj.2008.09.001

21. The Association for Medical Ultrasound Official Statement Page. URL: http://www.aium.org/publications/statements.aspx. Updated October 31, 2015. Accessed February 20, 2017.

22. Spinal Ultrasonography. United Health Care Commercial Medical Policy. Proprietary Information of United Health care. Copyright 2016 United Health Care Services, Inc. Effective 08/01/2016.

23. Ultrasonography of the Diagnosis the Degenerative−Dystrophic Changes in the Vertebral Motor Segment as a Potential Cause of Back Pain: Pictorial Essay / R. Ya. Abdullaiev et al. // J. Spine. 2017. Vol. 6. Iss. 5. 1000394. doi: 10.4172/2165−7939.1000394

Go on Top