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MEDIUM TERM FOLLOW UP OF PATIENTS WITH PERCUTANEOUS OR OPEN LUMBAR DISCECTOMY – CAN MRI ACCURATELY DIAGNOSE THE EXTRUDED DISC PROLAPSE?

Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, UK.

Study design: A prospective comparison of MRI findings with surgical findings in patients presenting to our spinal triage service with a prospective diagnosis of a lumbar disc herniation.

Objective: To investigate consistency between radiologists interpretation of MRI scans, and comparison between MRI and surgical findings, in an attempt to identify those patients suitable for percutaneous treatment.

Background: MRI has assumed a preeminent position in the diagnosis of lumbar disc prolapse.

Methods: 87 consecutive patients presenting with signs and symptoms suggestive of a lumbar disc prolapse that underwent an MRI and based on that a discectomy.

Results: Reliability tests show only fair agreement (k=0.36) between the radiologists and at best only moderate agreement (k=0.41) between the radiologists and surgical findings.

Conclusions: MRI is an excellent tool for diagnosis of a disc prolapse but does not appear to help in classifying discs suitable for percutaneous treatment.

Key Words: Correlation of surgical findings with Magnetic Resonance Imaging • Lumbar disc protrusion • Herniated Nucleus Pulposus

Please send correspondance to BASS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PE, UK.