A CADAVERIC STUDY COMPARING DISCOGRAPHY, MAGNETIC-RESONANCE-IMAGING, HISTOLOGY, AND MECHANICAL-BEHAVIOR OF THE HUMAN LUMBAR-DISK

被引：102

作者：

GUNZBURG, R ^{[1
]}

PARKINSON, R ^{[1
]}

MOORE, R ^{[1
]}

CANTRAINE, F ^{[1
]}

HUTTON, W ^{[1
]}

VERNONROBERTS, B ^{[1
]}

FRASER, R ^{[1
]}

机构：

[1] FREE UNIV BRUSSELS,BRUGMANN HOSP,DEPT ORTHOPAED SURG & TRAUMA,B-1050 BRUSSELS,BELGIUM

来源：

SPINE | 1992年 / 17卷 / 04期

关键词：

LOW-BACK PAIN; DISCOGRAPHY; MAGNETIC RESONANCE IMAGING; HISTOLOGY; ANULAR RIM LESIONS; ANULAR TEARS; FLEXION-ROTATION MOVEMENTS;

D O I：

10.1097/00007632-199204000-00007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The aims of this study were 1) to compare discography and magnetic resonance imaging scanning on cadaver specimens and to correlate these imaging procedures by examining all the discs histologically; and 2) to study the extent to which the amplitude of rotational movement in the neutral and flexed position at a certain level correlates with the morphologic appearance of that disc. Twenty-four human lumbar spines were harvested from cadavers between the ages of 19 and 75 years. Each specimen underwent standard radiography, magnetic resonance imaging scanning, discography, histologic examination, and measurement of axial rotation in a torsion apparatus. For practical reasons, all specimens did not undergo all of the examinations. Not all peripheral anular lesions were detected by discography. Histology showed rim lesions of the anterior anulus in 18% of discs with normal discography. The overall incidence of anterior and posterior anular tears was greater in discs where larger amplitudes of rotation were observed. To which extent the one is a consequence of the other or vice versa is not clear. Magnetic resonance imaging was found to be less specific than discography. However, it must be emphasized that no axial magnetic resonance imaging scans were taken in this study. Discs with significantly decreased amounts of nuclear material (observed at histology) can still produce normal magnetic resonance imaging images. Infolding of the inner layers of the anulus fibrosus (33% anterior, 4% posterior) was a frequently observed feature.

引用

页码：417 / 426

页数：10

共 28 条

[1]

Adams M.A., Hutton W.C., The relevance of torsion to the mechanical derangement of the lumbar spine, Spine, 6, (1981)

[2]

Bogduk N., Tynan W., Wilson S., The nerve supply to the human lumbar intervertebral discs, J Anat, 132, pp. 39-56, (1981)

[3]

Cossette J.W., Farfan H.F., Robertson G.H., Wells R.V., The instantaneous center of rotation of the third lumbar intervertebral joint, J Biomech, 4, pp. 149-153, (1971)

[4]

Farfan H.F., Cossette J.W., Robertson G.H., Wells R.V., Kraus H., The effects of torsion on the lumbar intervertebral joints: The role of torsion in the production of disc degeneration, J Bone Joint Surg, 52A, pp. 468-497, (1970)

[5]

Farfan H.F., Gracovetsky S., The nature of instability, Spine, 9, pp. 714-719, (1984)

[6]

Gibson M.J., Buckley J., Mawkinney R., Mulholland R.C., Worthington B.S., Magnetic resonance imaging and discography in the diagnosis of disc degeneration, J Bone Joint Surg, 68B, pp. 369-373, (1986)

[7]

Gunzburg R., Sandhu A., Fraser R.D., The value of computerised tomography in determining lumbar facet joint orientation, Journal of Spinal Disorders, 2, pp. 170-175, (1989)

[8]

Gunzburg R., Hutton W.C., Fraser R.D., Axial rotation of the lumbar spine and the effect of flexion: An in vitro and in vivo biomechanical study, Spine, 16, pp. 22-28, (1991)

[9]

Gunzburg R., Hutton W.C., Crane G., Fraser R.D., Role of the capsuloligamentous structures in rotation and combined flex- ion-rotation of the lumbar spine, Journal of Spinal Disorders (In Press)

[10]

Hickey D.S., Hukins D., Relation between the structure of the annulus fibrosus and the function and failure of the inter-vertebral disc, Spine, 5, pp. 106-116, (1980)

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