Lülisamba degeneratiivne patoloogia

Size: px
Start display at page:

Download "Lülisamba degeneratiivne patoloogia"

Transcription

1 Lülisamba degeneratiivne patoloogia MRT kool 13& Andres Nurmiste Tallinn

2 Degeneratiivne lülisamba patoloogia seljavalu on väga levinud kaebus väga levinud töövõimetuse põhjus väga palju tehakse MRT uuringuid degen. muutused kaasnevad normaalse vananemisega valu põhjuseid on palju enamasti paraneb vaatamata ravile, v.a. op.ravi

3 Seljavalu Vähemalt 80% inimestest on elu jooksul seljavalu episood(id) Sage perearstile pöördumise põhjus Suur osa kulutustest läheb piltide tegemisele 90% paraneb spontaanselt või vaatamata ravile 4..6 nädalaga Üldiselt ei soovitata kohe piltdiagnostikat, kuid erandiks on punaste ja kollaste lipukestega märgitud asjaolud / sümptomid

4 Punased lipukesed Fraktuur? Liiklusõnnetuses osalemine Kukkumine kõrgusest Kergem trauma osteoporootilisel pt-l. Valu torakaalosas. Tuumor või Infektsioon? Vanus >55a või <20a Ca anamneesis Hiljuti põetud bakteriaalne infektsioon, palavik, kaalulangus Immunosupressioon (kortikosteroidid, HIV,i/v narko.) Öised valud Cauda equina sündroom Progresseeruv neuroloogiline defitsiit

5 Kollased lipukesed Asjaolud mis nö varjutavad kliinilist pilti ja soodustavad vaevuste krooniliseks muutumist Negatiivne suhtumine, kartus, et haigus on pahaloomuline, invaliidistav Passiivsete ravimeetodite eelistamine, kartus ennast liigutada Depressiivsus Sotsiaalsed / materiaalsed probleemid

6 MRT ja degeneratiivne lülisamba Valikmeetod patoloogia : Nomenclature and Classification of Lumbar Disc Pathology (SPINE Volume 26, Number 5, pp E93 E113) Radioloogide ja neuroloogide ühisseminari ettekanded

7 Degeneratiivne haigus Diski degeneratsioon Veesisalduse langus Madaldumine lülide lõpp-plaatides ja subkondraalse luuüdi muutused (Modic et al 1988) I II III Anulaarfissuur Bulging e. väljakummumine Herniatsioon Fassett-liigeste degeneratsioon Artropaatia I II III Sünoviaaltsüstid! Ebastabiilsus? ei ole funktsionaane uuring; tava-mrt-s ainult kaudsed tunnused Degeneratiivne listees

8 MRT leid tervetel vabatahtlikel NEJM

9 Lülisamba MRT Hinnata: vertebra disk fassett-liigesed neuroforaamen spinaalkanal närvijuured seljaaju ümbritsevad pehmed koed

10 Vertebra: Lülisamba MRT lülikeha, lülikaar: kuju, MR signaal, joondumine, asend alumise lüli suhtes Disk küfoos, lordoosi, skolioos listees = nihe alumise lüli suhtes lülikeha madaldumine / kompressioon lõpp-plaatide degen. muutused (Modic 1988) spondüloos MR signaali muutus madaldumine

11 MRT Protokoll vähemalt 2 tasapinnas T2, T1 sag T2 ax (NB! mitte ainult 3 lõiku diski kohal) Soovitav täiendavalt: T2 rasvsupress. sag; MR myelo T2 kor T1 ax post Gd T1 ax, T1 sag (postop., dif dgn.)

12 NEJM

13 NEJM

14

15 Vertebra lülide asend üksteise suhtes (listees = nihe alumise lüli suhtes; küfoos, lordoos, skolioos = lateralisatsioon kaare alusel) lülikaar, jätked (sp-lüüs, üleminekulülid) lõpp-plaatide ja subkondraalse luuüdi muutused Modic I, II, III Modic MT, Steinberg PM, Ross JS, et al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166: , 1988.

16 Nomenclature and Classification of Lumbar Disc Pathology Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology SPINE Volume 26, Number 5, pp E93 E , Lippincott Williams & Wilkins, Inc.

17

18

19

20 A- protrusioon B- ekstrusioon migratsiooniga C- sekvester

21 A- protrusioon B ja C- ekstrusioon

22

23

24 Suhe PLL-iga: A- tsentraalne B-paratsentraalne (as- anterior epidural

25

26

27

28

29

30

31

32

33

34

35 )

36

37 Kontakt närvijuurega Grading of Lumbar Nerve Root Compromise on MR Images Pfirrmann et al; Radiology, February 2004

38 Närvijuure deviatsioon (dislokatsioon)

39 Närvijuure kompressioon

40 MR müelogramm

41

42

43

44

45

46

47 Sekvester

48 Sekvester T1 ax

49 Sekvester T1+Gd

50 Op?

51 Ei op.-tud

52

53

54 HIZ Anuluse rebend (?) Lumbalgia

55 Väga äge radikulopaatia

56

57 Paranenud! Neuroloogilise leiuta

58

59 Intervert. osteokondroos Modic

60

61 T2 fs

62 Lülisamba kaelaosa ei ole nimmeosa väike koopia Lülisamba kaelaosa

63

64

65

66

67

68 Müelopaatia

69

70

71 Torakaaldiskide herniatsioonid Th8-9>Th7-8>Th5-6

72

73

74

75

76

77 Sünoviaaltsüst

78 Listees

79

80

81 Spondülolistees, spondülolüüs Spondülolistees = lülikeha ettenihe alumise lülikeha suhtes Retrolistees = nihe taha Nihe külgsuunas Degeneratiivne (Spondülo)lüütiline Spondülolüüs Lülikaare pars interarticularis e defekt Diferentsimine Degeneratiivne vs lüütiline

82

83

84

85

86 Listees T2 ax

87 Foraminaalne stenoos

88

89 Listees?

90 Sp.-lüüs

91

92 Epiduraalne lipomatoos Liigne epiduraalne rasvkude, mis deformeerib dura kotti Võib kaasneda steroidraviga Doosi vähendamine, ravi lõpetamine võib anda efekti Seljavalu, müelopaatia, spinaalstenoosi, radikulopaatia sümptomid Kirurgiline ravi?

93

94

95 Postoperatiivne selg Diski herniatsiooni eemaldamine Stenoosi leevendamine Fusioon Segmendi ebastabiilsuse kõrvaldamine Deformatsioonide kõrvaldamine Vertebroplastika Väga palju erinevaid op. tehnikaid Tuumorite eemaldamine

96

97

98

99 POST-OPERATIIVSED MUUTUSED Operatsioonijärgsete seljavaevuste põhjused: Mehaanilised: residuaal-herniatsioon retsidiiv-herniatsioon stenoos (eri tasandil / operatsioonist põhjustatud) lateraalretsessi või neuroforaameni ahenemine instabiliteet lülidevaheliste liigeste düsfunktsioon ligamendi- või lihasrebend Põletikulised: epiduraalne fibroos arahnoidiit spondülodistsiit epiduraalne abstsess Diagnostilised raskused: valu tõeline allikas on jäänud leidmata disk teises vahemikus kui opereeritud perifeerse närvi- või liigesepatoloogia Kirurgilised: närvijuure kahjustus pseudomeningocele post.op. hematoom paraspinoossete lihaste kahjustus spinaalsete ligamentide rebend

100

101

102 Arahnoidiit

103

104 Pseudomeningotseele

105

106

107 Hemilaminektoomia- Järgne listees

108

109 Presentatsiooni lõpp Tänan!

Lülisamba traumaatiline vigastus (TLICS) 5. veebr Erki Parri

Lülisamba traumaatiline vigastus (TLICS) 5. veebr Erki Parri Lülisamba traumaatiline vigastus (TLICS) Erki Parri 5. veebr. 2014 ThoracolumbarInjuryClassification and SeverityScore( TLICS) Eelnevatel klassifikatsiooni süst. on piiratud prognostiline väärtus Kirurgilise

More information

LÜLISAMBA PÕLETIKULISED HAIGUSED. Äli Tõnnov SA PERH Radioloogiakeskus

LÜLISAMBA PÕLETIKULISED HAIGUSED. Äli Tõnnov SA PERH Radioloogiakeskus LÜLISAMBA PÕLETIKULISED HAIGUSED Äli Tõnnov SA PERH Radioloogiakeskus Põletik Põletik on organismi kohalik kaitsekohastusliku iseloomuga reaktsioon, mis on suunatud kahjustava faktori ja tekkinud kahjustuse

More information

Haigusjuht. Helen Kikerpill II a arst-resident radioloogia

Haigusjuht. Helen Kikerpill II a arst-resident radioloogia Haigusjuht Helen Kikerpill II a arst-resident radioloogia 21.04.2011 Kliinilised andmed: valu paremas puusas [Manaster et al] 21.04.2011 MRT uuring lülisamba nimmeosast Olulist spinaalkanali ahenemist

More information

DOWNLOAD OR READ : PREVALENCE OF MODIC DEGENERATIVE MARROW CHANGES IN THE CERVICAL SPINE PDF EBOOK EPUB MOBI

DOWNLOAD OR READ : PREVALENCE OF MODIC DEGENERATIVE MARROW CHANGES IN THE CERVICAL SPINE PDF EBOOK EPUB MOBI DOWNLOAD OR READ : PREVALENCE OF MODIC DEGENERATIVE MARROW CHANGES IN THE CERVICAL SPINE PDF EBOOK EPUB MOBI Page 1 Page 2 prevalence of modic degenerative marrow changes in the cervical spine prevalence

More information

Südamepuudulikkus: iseloomulikud muutused Rö-pildil ning KT-uuringul. Tatjana Vask

Südamepuudulikkus: iseloomulikud muutused Rö-pildil ning KT-uuringul. Tatjana Vask Südamepuudulikkus: iseloomulikud muutused Rö-pildil ning KT-uuringul Tatjana Vask Piltdiagnostika kardioloogias 2012 Täna kavas: Rindkere Rö- ja KT-uuringud südamepuudulikkusega patsientidel Südamepuudulikkusega

More information

Comprehension of the common spine disorder.

Comprehension of the common spine disorder. Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy

More information

Imaging Degeneration of the Lumbar Spine: What It All Means.

Imaging Degeneration of the Lumbar Spine: What It All Means. Imaging Degeneration of the Lumbar Spine: What It All Means www.fisiokinesiterapia.biz Spine Nomenclature and Evidence for Imaging p, Talk Objectives Background Nomenclature for disc findings Who should

More information

Riste Saat ITKH, HUS. MRT-kool Kõrva ja temporaalluu MRT

Riste Saat ITKH, HUS. MRT-kool Kõrva ja temporaalluu MRT Kõrva ja temporaalluu MRT MRT-kool 2012 Riste Saat ITKH, HUS Näidustused Tehnika Anatoomia Patoloogia Pseudolesioonid ja diagnostilised vead Kõrva MRT näidustused n Sensorineuraalne kuulmislangus, tinnitus,

More information

ÕLAVALU FUNKTSONAALNE DIAGNOSTIKA

ÕLAVALU FUNKTSONAALNE DIAGNOSTIKA ÕLAVALU FUNKTSONAALNE DIAGNOSTIKA Dr.TOOMAS TEIN SA TÜK Traumatoloogia-ortopeedia kliinik Erakliinik MEDEX 2012 Õlaliigese valu Õlavalu esineb 7 34 % rahvastikust (21 % > 70 a.) 40 50 % läheb perearsti

More information

Objectives. Comprehension of the common spine disorder

Objectives. Comprehension of the common spine disorder Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy

More information

Reliability of change in lumbar MRI findings

Reliability of change in lumbar MRI findings Reliability of change in lumbar MRI findings Poster No.: C-0539 Congress: ECR 2012 Type: Scientific Exhibit Authors: L. Berg 1, O. Gjertsen 2, C. Hellum 2, G. F. Neckelmann 1, L. G. Johnsen 3, G. E. Eide

More information

Kopsuvälise paikmega TB (KVTB) Ekstrapulmonaalne TB (EPTB)

Kopsuvälise paikmega TB (KVTB) Ekstrapulmonaalne TB (EPTB) Kopsuvälise paikmega TB (KVTB) Ekstrapulmonaalne TB (EPTB) Kopsuväline TB A high incidence of EPTB has become somehow synonymous with the HIV infection Kopsuvälised paikmed - 1-7% TB juhtudest Mõjutavad:

More information

Spine. Neuroradiology. Spine. Spine Pathology. Distribution of fractures. Radiological algorithm. Role of radiology 18/11/2015

Spine. Neuroradiology. Spine. Spine Pathology. Distribution of fractures. Radiological algorithm. Role of radiology 18/11/2015 Spine Neuroradiology Spine Prof.Dr.Nail Bulakbaşı X Ray: AP/L/Oblique Vertebra & disc spaces CT & CTA Vertebra, discs, vessels MRI & MRA Vertebra, disc, vessels, meninges Spinal cord & nerves Myelography

More information

MR imaging the post operative spine - What to expect!

MR imaging the post operative spine - What to expect! MR imaging the post operative spine - What to expect! Poster No.: C-2334 Congress: ECR 2012 Type: Educational Exhibit Authors: A. Jain, M. Paravasthu, M. Bhojak, K. Das ; Warrington/UK, 1 1 1 2 1 2 Liverpool/UK

More information

RADICULOPATHY AN INTRODUCTION TO

RADICULOPATHY AN INTRODUCTION TO AN INTRODUCTION TO RADICULOPATHY This booklet provides general information on radiculopathy. It is not meant to replace any personal conversations that you might wish to have with your physician or other

More information

Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults

Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults ORIGINAL ARTICLE SPINE SURGERY AND RELATED RESEARCH Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults Kosuke Sugiura, Toshinori Sakai, Fumitake Tezuka, Kazuta

More information

Degenerative Disc Disease. Nafi Aygun, MD. Associate Professor of Radiology

Degenerative Disc Disease. Nafi Aygun, MD. Associate Professor of Radiology Degenerative Disc Disease Nafi Aygun, MD. Associate Professor of Radiology Big Problem Great majority of adults suffer from at least one episode of acute low back pain during life time Disc degeneration

More information

Ekstrapulmonaalne TB (EPTB) synonymous with the HIV infection

Ekstrapulmonaalne TB (EPTB) synonymous with the HIV infection Kopsuvälise paikmega TB (KVTB) Ekstrapulmonaalne TB (EPTB) A hi h i id f EPTB h b h A high incidence of EPTB has become somehow synonymous with the HIV infection Kopsuväline TB Kopsuvälised paikmed - 10-70%

More information

Spondülodistsiit. Marek Tiivel Radioloogia III aasta resident

Spondülodistsiit. Marek Tiivel Radioloogia III aasta resident Spondülodistsiit Marek Tiivel Radioloogia III aasta resident Sissejuhatus Infektsiooni lokatsioon aksiaalses skeletis lülikeha (spondüliit) intervertebraalne disk (distsiit) ligamendid ja paravertebraalsed

More information

Magnetic resonance imaging findings in patients with low backache

Magnetic resonance imaging findings in patients with low backache Original Article Magnetic resonance imaging findings in patients with low backache Narayan Bikram Thapa 1, Suraj Bajracharya 2 1 Department of Radiology, KIST Medial College Teaching Hospital, Lalitpur,

More information

Lumbar total disc replacement

Lumbar total disc replacement The Norwegian TDR Study Lumbar total disc replacement Predictors for long-term outcome Background Lumbar total disc replacement (TDR) is a surgical option for selected patients with chronic low back pain

More information

The Role of Surgery in the Treatment of Low Back Pain and Radiculopathy. Christian Etter, MD, Spine Surgeon Zürich, Switzerland

The Role of Surgery in the Treatment of Low Back Pain and Radiculopathy. Christian Etter, MD, Spine Surgeon Zürich, Switzerland The Role of Surgery in the Treatment of Low Back Pain and Radiculopathy Christian Etter, MD, Spine Surgeon Zürich, Switzerland WW Fusion Volume by Disorder 2004E % Tumor/Trauma 11% Deformity 15% Degeneration

More information

NVM5 NERVE MONITORING SYSTEM AN INTRODUCTION TO

NVM5 NERVE MONITORING SYSTEM AN INTRODUCTION TO AN INTRODUCTION TO NVM5 NERVE MONITORING SYSTEM This booklet is designed to inform you about the use of NVM5 nerve monitoring in the course of your surgery. It is not meant to replace any personal conversations

More information

HERNIATED DISCS AN INTRODUCTION TO

HERNIATED DISCS AN INTRODUCTION TO AN INTRODUCTION TO HERNIATED S This booklet provides general information on herniated discs. It is not meant to replace any personal conversations that you might wish to have with your physician or other

More information

Kõhre patoloogia. Kõhre vigastused: sport. Kõhre patoloogia. Diagnoos Kõhre vigastused: artroskoopia versus MRT. William Hunter ( )

Kõhre patoloogia. Kõhre vigastused: sport. Kõhre patoloogia. Diagnoos Kõhre vigastused: artroskoopia versus MRT. William Hunter ( ) William Hunter (1718 1783) Kõhre patoloogia Madis Rahu Ortopeedia Arstid/TÜ Sporditrauma Keskus Pärnu 10.11.2016 Hunter W. Of the structure and diseases of articular cartilages. Philos Trans R Soc Lond

More information

Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration

Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration SPINE Volume 26, Number 17, pp 1873 1878 2001, Lippincott Williams & Wilkins, Inc. Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration Christian W. A. Pfirrmann, MD,* Alexander

More information

Anthem Blue Cross and Blue Shield Central Region Clinical Claim Edit

Anthem Blue Cross and Blue Shield Central Region Clinical Claim Edit Subject: Laminotomy (Hemilaminectomy) with Decompression of Nerve Root(s), Including Partial Facetectomy, Foraminotomy and/or Excision of Herniated Intervertebral Disc, Reexploration, Single Interspace-Lumbar

More information

Epidemiology of Low back pain

Epidemiology of Low back pain Low Back Pain Definition Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like the mid or upper back, a inguinal

More information

University of Jordan. Professor Freih Abuhassan -

University of Jordan. Professor Freih Abuhassan - Freih Odeh Abu Hassan F.R.C.S.(Eng.), F.R.C.S.(Tr.& Orth.). Professor of Orthopedics University of Jordan 1 A. Sacroiliitis History Trauma is very common Repetitive LS motion--lumbar rotation or axial

More information

Lumbar disc herniation

Lumbar disc herniation Lumbar disc herniation Thomas Kishen Spine Surgeon Sparsh Hospital for Advanced Surgeries Bangalore Symptoms and Signs Radicular Pain in the distribution of the involved nerve Neurological deficit motor,

More information

Spinal Cord Injuries: The Basics. Kadre Sneddon POS Rounds October 1, 2003

Spinal Cord Injuries: The Basics. Kadre Sneddon POS Rounds October 1, 2003 Spinal Cord Injuries: The Basics Kadre Sneddon POS Rounds October 1, 2003 Anatomy Dorsal columntouch, vibration Corticospinal tract- UMN Anterior horn-lmn Spinothalamic tractpain, temperature (contralateral)

More information

RETROLISTHESIS. Retrolisthesis. is found mainly in the cervical spine and lumbar region but can also be often seen in the thoracic spine

RETROLISTHESIS. Retrolisthesis. is found mainly in the cervical spine and lumbar region but can also be often seen in the thoracic spine RETROLISTHESIS A retrolisthesis is a posterior displacement of one vertebral body with respect to adjacent vertebrae Typically a vertebra is to be in retrolisthesis position when it translates backward

More information

The ABC s of LUMBAR SPINE DISEASE

The ABC s of LUMBAR SPINE DISEASE The ABC s of LUMBAR SPINE DISEASE Susan O. Smith ANP-BC University of Rochester Department of Neurological Surgery Diagnosis/Imaging/Surgery of Lumbar Spine Disorders Objectives Identify the most common

More information

SpineFAQs. Lumbar Spondylolisthesis

SpineFAQs. Lumbar Spondylolisthesis SpineFAQs Lumbar Spondylolisthesis Normally, the bones of the spine (the vertebrae) stand neatly stacked on top of one another. The ligaments and joints support the spine. Spondylolisthesis alters the

More information

Kaelavaluga haige käsitluse põhimõtted

Kaelavaluga haige käsitluse põhimõtted Kaelavaluga haige käsitluse põhimõtted Ando Vaher, Väino Sinisalu TÜ Kliinikumi närvikliinik Võtmesõnad: kaelavalu, kaelaradikulopaatia, nn whiplash-sündroom, mittesteroidsed põletikuvastased ained Kaelavalu

More information

101 PLIF trussed with a titanium intersomatic parallelepipedic cage and a posterior instrumentation. Daniel Gastambide (Centre Tourville, Paris)

101 PLIF trussed with a titanium intersomatic parallelepipedic cage and a posterior instrumentation. Daniel Gastambide (Centre Tourville, Paris) 101 PLIF trussed with a titanium intersomatic parallelepipedic cage and a posterior instrumentation Daniel Gastambide (Centre Tourville, Paris) 101 PLIF MATERIAL & METHODS Surgical Indications Hyperalgic

More information

Back pain and bladder problems

Back pain and bladder problems Back pain and bladder problems Search Learn the causes and symptoms of chronic back pain, as well as safe techniques that provide back pain relief better than prescriptions drugs. If back pain is reducing

More information

Assissment of Extradural Degenerative Disease with Gd DTPA-Enhanced MR Imaging: Correlation with Surgical and Pathologic Findings

Assissment of Extradural Degenerative Disease with Gd DTPA-Enhanced MR Imaging: Correlation with Surgical and Pathologic Findings 1243 ssissment of Extradural Degenerative Disease with Gd DTP-Enhanced MR Imaging: Correlation with Surgical and Pathologic Findings - - ' \. l JeffreyS. Ross 1 Michael T. Modic 1 Thomas J. Masaryk 1 John

More information

The Effect of Lumbar Disc Degeneration on Positional Changes in the Lumbar Lordosis: a cross-sectional comparison with healthy controls

The Effect of Lumbar Disc Degeneration on Positional Changes in the Lumbar Lordosis: a cross-sectional comparison with healthy controls The Effect of Lumbar Disc Degeneration on Positional Changes in the Lumbar Lordosis: a cross-sectional comparison with healthy controls Bjarke B Hansen, MD* Tom Bendix, MD, DMSc, Jacob Grindsted, MD Henning

More information

Pars Injection for Lumbar Spondylolysis

Pars Injection for Lumbar Spondylolysis Pars Injection for Lumbar Spondylolysis Issue 4: March 2016 Review date: February 2019 Following your recent investigations and consultation with your spinal surgeon, a possible cause for your symptoms

More information

The imaging features of spondylolisthesis : what the clinician needs to know

The imaging features of spondylolisthesis : what the clinician needs to know The imaging features of spondylolisthesis : what the clinician needs to know Poster No.: C-1018 Congress: ECR 2011 Type: Authors: Educational Exhibit D. Shah 1, C. J. Burke 1, A. C. andi 2, R. Houghton

More information

Degenerative marrow (modic) changes on cervical spine MRI scans: prevalence, inter- and intra-examiner reliability and link to disc herniation

Degenerative marrow (modic) changes on cervical spine MRI scans: prevalence, inter- and intra-examiner reliability and link to disc herniation Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2011 Degenerative marrow (modic) changes on cervical spine MRI scans: prevalence,

More information

LUMBAR SPINAL STENOSIS

LUMBAR SPINAL STENOSIS LUMBAR SPINAL STENOSIS Always occurs in the mobile segment. Factors play role in Stenosis Pre existing congenital or developmental narrowing of the lumbar spinal canal Translation of one anatomic segment

More information

VERTEBRAL COLUMN ANATOMY IN CNS COURSE

VERTEBRAL COLUMN ANATOMY IN CNS COURSE VERTEBRAL COLUMN ANATOMY IN CNS COURSE Vertebral body Sections of the spine Atlas (C1) Axis (C2) What type of joint is formed between atlas and axis? Pivot joint What name is given to a fracture of both

More information

Lumbar Disc Prolapse: Management and Outcome Analysis of 96 Surgically treated Patients

Lumbar Disc Prolapse: Management and Outcome Analysis of 96 Surgically treated Patients Lumbar Disc Prolapse: Management and Outcome Analysis of 96 Surgically treated Patients A. Akbar ( Department of Neurosurgery, Chandka Medical College, Larkana. ) A. Mahar ( Department of Orthopedic Surgery,

More information

Magnetic Resonance Imaging Interpretation in Patients With Symptomatic Lumbar Spine Disc Herniations

Magnetic Resonance Imaging Interpretation in Patients With Symptomatic Lumbar Spine Disc Herniations Magnetic Resonance Imaging Interpretation in Patients With Symptomatic Lumbar Spine Disc Herniations Comparison of Clinician and Radiologist Readings Jon D. Lurie, MD, MS,* David M. Doman, MD, Kevin F.

More information

NEURORADIOLOGY. Part III. Angela Csomor University of Szeged Department of Radiology

NEURORADIOLOGY. Part III. Angela Csomor University of Szeged Department of Radiology NEURORADIOLOGY Part III Angela Csomor University of Szeged Department of Radiology DISEASES OF SPINE AND SPINAL CORD I. Non-tumourous diseases developmental anomalies vascular disorders inflammatory processes

More information

Hidayatullah Hamidi. MD Consultant Radiologist. Lumbar Spine MR Imaging Interpretation

Hidayatullah Hamidi. MD Consultant Radiologist. Lumbar Spine MR Imaging Interpretation Hidayatullah Hamidi. MD Consultant Radiologist Lumbar Spine MR Imaging Interpretation 13/12/2018 Presenter Hidayatullah Hamidi Consultant Radiologist, Radiology PGME program director, FMIC, Kabul, Afghanistan

More information

MAS TLIF MAXIMUM ACCESS SURGERY TRANSFORAMINAL LUMBAR INTERBODY FUSION AN INTRODUCTION TO

MAS TLIF MAXIMUM ACCESS SURGERY TRANSFORAMINAL LUMBAR INTERBODY FUSION AN INTRODUCTION TO AN INTRODUCTION TO MAS TLIF MAXIMUM ACCESS SURGERY TRANSFORAMINAL LUMBAR INTERBODY FUSION This booklet is designed to inform you about the Maximum Access Surgery (MAS ) Transforaminal Lumbar Interbody

More information

The ABC s of LUMBAR SPINE DISEASE

The ABC s of LUMBAR SPINE DISEASE The ABC s of LUMBAR SPINE DISEASE Susan O. Smith ANP-BC University of Rochester Department of Neurological Surgery URMC Neurosurgery APP s Objectives Identify the most common pathology that leads to spine

More information

River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management.

River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management. River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management. Chicago, Illinois, 60611 Phone: (888) 951-6471 Fax: (888) 961-6471 Clinical

More information

Fusion and repeat discectomy following single level open lumbar discectomies. Survival analysis

Fusion and repeat discectomy following single level open lumbar discectomies. Survival analysis Fusion and repeat discectomy following single level open lumbar discectomies. Survival analysis Dr John Mortimer Mr Chris Hoffman CCDHB and TBI Health group Sciatica = Leg Dominant Pain Patients referred

More information

Can a bulging disc cause ear pain

Can a bulging disc cause ear pain Can a bulging disc cause ear pain that can be attributed to their nonotogenic ear pain: 37, cervical spine degenerative disease (eg, disc changes and herniation, osteophytes, spinal/ foramen. Surgeon says

More information

Rome, 9-11 July MASSIMO GALLUCCI Neuroradiology Unit,, University-Hospital L AquilaL. Aquila- ITALY massimo.gallucci

Rome, 9-11 July MASSIMO GALLUCCI Neuroradiology Unit,, University-Hospital L AquilaL. Aquila- ITALY massimo.gallucci Rome, 9-11 July 2009 MASSIMO GALLUCCI Neuroradiology Unit,, University-Hospital 67100 L AquilaL Aquila- ITALY massimo.gallucci gallucci@cc.univaq.itit BEFORE AFTER Diagnostic Knowledge: main need for being

More information

Imaging the post-operative spine - are we united in where we stand?

Imaging the post-operative spine - are we united in where we stand? Imaging the post-operative spine - are we united in where we stand? Poster No.: C-2424 Congress: ECR 2015 Type: Authors: Keywords: DOI: Scientific Exhibit J. Kumaraguru, N. Kandasamy, D. A. Elias, J. M.

More information

Thoracolumbar Spine Conditions: Treatment and Return to Play

Thoracolumbar Spine Conditions: Treatment and Return to Play Thoracolumbar Spine Conditions: Treatment and Return to Play C H R I S T O P H E R B U R K S, MD B I E N V I L L E O R T H O P A E D I C S P E C I A L I S T S O C E A N S P R I N G S, MS Thoracolumbar

More information

Kahjustus võib esineda mitmel tasemel, nt AAA esinemine tõstab TAA esinemise tõenäosust Torakoabdominaalne

Kahjustus võib esineda mitmel tasemel, nt AAA esinemine tõstab TAA esinemise tõenäosust Torakoabdominaalne MAIRE KIITAM PERH DETSEMBER 2015 AD aordi dissektsioon BAV bikuspiidne aordiklappection CoA- aordi koarktatsioon IMH intramuraalne hematoom IRAD International Registry of Aortic Dissection TAA - torakaalaordi

More information

1 Normal Anatomy and Variants

1 Normal Anatomy and Variants 1 Normal Anatomy and Variants 1.1 Normal Anatomy MR Technique. e standard MR protocol for a routine evaluation of the spine always comprises imaging in sagittal and axial planes, while coronal images are

More information

Evaluation of Degenerative Lumbosacral Diseases and Common Location of Disc Herniations causing Radiculopathy

Evaluation of Degenerative Lumbosacral Diseases and Common Location of Disc Herniations causing Radiculopathy Original Article Evaluation of Degenerative Lumbosacral Diseases and Common Location of Disc Herniations causing Radiculopathy DOI: 10.7860/IJARS/2017/27541:2282 Radiology Section Mallikarjun MD, Chetan

More information

ACDF. Anterior Cervical Discectomy and Fusion. An introduction to

ACDF. Anterior Cervical Discectomy and Fusion. An introduction to An introduction to ACDF Anterior Cervical Discectomy and Fusion This booklet provides general information on ACDF. It is not meant to replace any personal conversations that you might wish to have with

More information

102 Results RESULTS. Age Mean=S.D Range 42= years -84 years Number % <30 years years >50 years

102 Results RESULTS. Age Mean=S.D Range 42= years -84 years Number % <30 years years >50 years 102 Results RESULTS A total of 50 cases were studied 39 males and 11females.Their age ranged between 16 years and 84 years (mean 42years). T1 and T2WI were acquired for all cases in sagittal and axial

More information

Module 1: Basic Comprehensive Course

Module 1: Basic Comprehensive Course The Hellenic Spine Society organize 5 modules according to the following program, which is based on the Eurospine program Module 1: Basic Comprehensive Course SESSION1: SPINE THE BIGGER PICTURE Evidence

More information

WHAT IS SCIATICA? Apart from the compression of one of the nerves, there are other known causes of sciatica which include:

WHAT IS SCIATICA? Apart from the compression of one of the nerves, there are other known causes of sciatica which include: WHAT IS SCIATICA? If you suffer from Sciatica, or you re close to someone who does, you already know that it is one of those conditions that can be quite overwhelming and incapacitating while causing a

More information

Degenerative Disease of the Spine

Degenerative Disease of the Spine Degenerative Disease of the Spine Introduction: I. Anatomy Talk Overview II. Overview of Disease Processes: A. Spondylosis B. Intervertebral Disc Disease III. Diagnosis IV. Therapy Introduction: Myelopathy

More information

Thoracic and Lumbar Spine Fractures and Dislocations: Assessment and Classification

Thoracic and Lumbar Spine Fractures and Dislocations: Assessment and Classification Thoracic and Lumbar Spine Fractures and Dislocations: Assessment and Classification Mark L Prasarn MD University of Texas Dept of Orthopaedic Surgery Houston, Texas Updated 7/2016 Anatomy of the Spine

More information

Medical Policy Original Effective Date: Revised Date: Page 1 of 11

Medical Policy Original Effective Date: Revised Date: Page 1 of 11 Page 1 of 11 Content Disclaimer Description Coverage Determination Clinical Indications Lumbar Spine Surgery Lumbar Spine Surgery Description Indication Coding Lumbar Spinal Fusion (single level)surgery

More information

Icd 10 degenerative joint disease back

Icd 10 degenerative joint disease back Icd 10 degenerative joint disease back Search This article appeared in the January issue of the Radiology Coding & Compliance Expert. Many imaging studies are ordered because the patient is experiencing

More information

Objectives. Identify and differentiate appropriate surgical cases. Good Surgical Outcomes

Objectives. Identify and differentiate appropriate surgical cases. Good Surgical Outcomes ECHO February 5 th, 2015 Surgical Selection for Low Back Pain Objectives Identify and differentiate appropriate surgical cases Disclosures Medical director for UHN Rehabilitations Solution Back and Neck

More information

Lower Back Pain. Sensory motor function. 1 Principles of Exercise Therapy. Global muscles vs Local muscles. Research in Spine Rehabilitation

Lower Back Pain. Sensory motor function. 1 Principles of Exercise Therapy. Global muscles vs Local muscles. Research in Spine Rehabilitation 1 Principles of Exercise Therapy Lower Back Pain 1. Facet joint pain 2. Spondylolysis & Spondylisthesis 1. Exercise Therapy turns the patient into an active participant and not just a passive recipient

More information

Changes in a Lumbar Disc Extrusion After Cox Technic Flexion Distraction Therapy in a 44 year old Office Worker. Submitted by

Changes in a Lumbar Disc Extrusion After Cox Technic Flexion Distraction Therapy in a 44 year old Office Worker. Submitted by Changes in a Lumbar Disc Extrusion After Cox Technic Flexion Distraction Therapy in a 44 year old Office Worker History Submitted by Dr Joel Dixon B.App.Sc (Chiropractic) J.P. Melbourne Spine Clinic Melbourne,

More information

Pathophysiology of lumbar disc degeneration: a review of the literature. Neurosurg Focus 13 (2): August, 2002

Pathophysiology of lumbar disc degeneration: a review of the literature. Neurosurg Focus 13 (2): August, 2002 Pathophysiology of lumbar disc degeneration: a review of the literature Neurosurg Focus 13 (2): August, 2002 MICHAEL D. MARTIN, M.D., CHRISTOPHER M. BOXELL, M.D., F.A.C.S., AND DAVID G. MALONE, M.D. FROM

More information

NECK AND BACK PAIN AN INTRODUCTION TO

NECK AND BACK PAIN AN INTRODUCTION TO AN INTRODUCTION TO NECK AND BACK PAIN This booklet provides general information on neck and back pain. It is not meant to replace any personal conversations that you might wish to have with your physician

More information

Original Date: October 2015 LUMBAR SPINAL FUSION FOR

Original Date: October 2015 LUMBAR SPINAL FUSION FOR National Imaging Associates, Inc. Clinical guidelines Original Date: October 2015 LUMBAR SPINAL FUSION FOR Page 1 of 9 INSTABILITY AND DEGENERATIVE DISC CONDITIONS FOR CMS (MEDICARE) MEMBERS ONLY CPT4

More information

Low back pain, radiculopathy left leg icd 10 code

Low back pain, radiculopathy left leg icd 10 code Home Search Low back pain, radiculopathy left leg icd 10 code 2018 ICD - 10 code for Radiculopathy is M54.1. Lookup the complete ICD 10 Code details for M54.1.. Low back pain ; M54.6 - Pain in thoracic

More information

Case Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2

Case Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2 Case Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2 Case 79 yo M with hx of T3N0 colon cancer diagnosed in 2008 metastatic liver disease s/p liver segmentectomy 2009

More information

ESCOME Pre-Course Outline (v1.09)

ESCOME Pre-Course Outline (v1.09) ESCOME Pre-Course Outline (v1.09) 1. Basics of Spinal Disorders Introduction to Spinal Surgery Spinal Anatomy Introduction to Vertebral Anatomical Concepts Anatomy and Function of Joints and Ligaments

More information

Prevalence and Factors Associated with Modic Changes of Lumbosacral Spine in Nepalese Patients with Chronic Low Back Pain

Prevalence and Factors Associated with Modic Changes of Lumbosacral Spine in Nepalese Patients with Chronic Low Back Pain ORIGINAL ARTICLE Prevalence and Factors Associated with Modic Changes of Lumbosacral 10.5005/jp-journals-10039-1183 Spine in Nepalese Patients Prevalence and Factors Associated with Modic Changes of Lumbosacral

More information

L-SPINE. At C1-2 --> C2 exits At C7-T1 --> C8 exits At T1-T2 -->T1 exits At T12-L1 -->T12 exits At L1-2-->L1 exits At L5-S1-->L5 exits

L-SPINE. At C1-2 --> C2 exits At C7-T1 --> C8 exits At T1-T2 -->T1 exits At T12-L1 -->T12 exits At L1-2-->L1 exits At L5-S1-->L5 exits L-SPINE CERVICAL SPINE: C1 exits above C1 vert body THORACIC & LUMBAR SPINE: T1 nerve exits below T1 at T1-T2 and similarly, L1 nerve exists below L1 at L1-2; at L3-4 level exiting L3 nerve root within

More information

_CH01redo.qxd 9/24/07 3:07 PM Page 1. [Half-Title to come]

_CH01redo.qxd 9/24/07 3:07 PM Page 1. [Half-Title to come] 10752-01_CH01redo.qxd 9/24/07 3:07 PM Page 1 [Half-Title to come] 10752-01_CH01redo.qxd 9/24/07 3:07 PM Page 2 THE BACK Lippincott Williams & Wilkins atlas of ANATOMY CHAPTER 1 Plate 1-01 Palpable Structures

More information

Lumbar Spinal Epidural Lipomatosis: Prevalence and Patterns Abstract: Keywords: Introduction II. Materials And Methods

Lumbar Spinal Epidural Lipomatosis: Prevalence and Patterns Abstract: Keywords: Introduction II. Materials And Methods IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 10 Ver. VII (October. 2016), PP 27-32 www.iosrjournals.org Lumbar Spinal Epidural Lipomatosis:

More information

Module: #15 Lumbar Spine Fusion. Author(s): Jenni Buckley, PhD. Date Created: March 27 th, Last Updated:

Module: #15 Lumbar Spine Fusion. Author(s): Jenni Buckley, PhD. Date Created: March 27 th, Last Updated: Module: #15 Lumbar Spine Fusion Author(s): Jenni Buckley, PhD Date Created: March 27 th, 2011 Last Updated: Summary: Students will perform a single level lumbar spine fusion to treat lumbar spinal stenosis.

More information

Infektsioon artroskoopia järgselt. Madis Rahu ETOS tüsistuste seminar Eivere

Infektsioon artroskoopia järgselt. Madis Rahu ETOS tüsistuste seminar Eivere Infektsioon artroskoopia järgselt Madis Rahu ETOS tüsistuste seminar Eivere 24.04.2015 Infektsioon artroskoopial Enim esinev artroskoopia komplikatsioon: 0,07 kuni 0,4% kirjanduse andmetel Ainuke põhjus

More information

Common Low Back Injuries in Dancers

Common Low Back Injuries in Dancers Common Low Back Injuries in Dancers Bones Anatomy of the Spine Ligaments & Discs Muscles Quadratus Lumborum (QL) Muscle Strain or Trigger Point The QL originates from the posterior iliac crest and inserts

More information

Anatomy of the Spine. Figure 1. (left) The spine has three natural curves that form an S-shape; strong muscles keep our spine in alignment.

Anatomy of the Spine. Figure 1. (left) The spine has three natural curves that form an S-shape; strong muscles keep our spine in alignment. 1 2 Anatomy of the Spine Overview The spine is made of 33 individual bony vertebrae stacked one on top of the other. This spinal column provides the main support for your body, allowing you to stand upright,

More information

Changes in a Lumbar Disc Extrusion After Cox Technic Flexion Distraction Therapy in a 44 year old Office Worker: Pre and Post MRI Images

Changes in a Lumbar Disc Extrusion After Cox Technic Flexion Distraction Therapy in a 44 year old Office Worker: Pre and Post MRI Images Cox Technic Case Report #170 published at www.coxtechnic.com (sent 6/14/17) 1 Changes in a Lumbar Disc Extrusion After Cox Technic Flexion Distraction Therapy in a 44 year old Office Worker: Pre and Post

More information

What causes new vertebral endplate signal changes (modic changes)?

What causes new vertebral endplate signal changes (modic changes)? What causes new vertebral endplate signal changes (modic changes)? Poster No.: C-2417 Congress: ECR 2010 Type: Scientific Exhibit Topic: Musculoskeletal Authors: T. S. Jensen 1, P. Kjaer 2, L. Korsholm

More information

Patient Information MIS LLIF. Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques

Patient Information MIS LLIF. Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques Patient Information MIS LLIF Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques Table of Contents Anatomy of Spine....2 General Conditions of the Spine....4 What is Spondylolisthesis....5

More information

Modic type I changes of the lumbar spine in golfers

Modic type I changes of the lumbar spine in golfers Skeletal Radiol (2011) 40:467 473 DOI 10.1007/s00256-010-1066-2 CASE REPORT Modic type I changes of the lumbar spine in golfers Jason Mefford & Koichi Sairyo & Toshinori Sakai & Justin Hopkins & Madoka

More information

Asymmetrical degenerative marrow (Modic) changes in cervical spine: prevalence, correlative factors, and surgical outcomes

Asymmetrical degenerative marrow (Modic) changes in cervical spine: prevalence, correlative factors, and surgical outcomes Gao et al. Journal of Orthopaedic Surgery and Research (2018) 13:85 https://doi.org/10.1186/s13018-018-0807-0 RESEARCH ARTICLE Open Access Asymmetrical degenerative marrow (Modic) changes in cervical spine:

More information

SPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION

SPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION CLINICAL VIGNETTE 2017; 3:2 SPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION Editor-in-Chief: Idowu, Olufemi E. Neurological surgery Division, Department of Surgery, LASUCOM/LASUTH, Ikeja, Lagos, Nigeria.

More information

Three-dimensional radiological classification of lumbar disc herniation in relation to surgical outcome

Three-dimensional radiological classification of lumbar disc herniation in relation to surgical outcome International Orthopaedics (SICOT) (2009) 33:725 730 DOI 10.1007/s00264-008-0519-x ORIGINAL PAPER Three-dimensional radiological classification of lumbar disc herniation in relation to surgical outcome

More information

Diffusion-weighted MRI (DWI) "claw sign" is useful in differentiation of infectious from degenerative Modic I signal changes of the spine

Diffusion-weighted MRI (DWI) claw sign is useful in differentiation of infectious from degenerative Modic I signal changes of the spine Diffusion-weighted MRI (DWI) "claw sign" is useful in differentiation of infectious from degenerative Modic I signal changes of the spine Poster No.: C-0894 Congress: ECR 2012 Type: Scientific Exhibit

More information

ProDisc-L Total Disc Replacement. IDE Clinical Study.

ProDisc-L Total Disc Replacement. IDE Clinical Study. ProDisc-L Total Disc Replacement. IDE Clinical Study. A multi-center, prospective, randomized clinical trial. Instruments and implants approved by the AO Foundation Table of Contents Indications, Contraindications

More information

Origin of lumbar spinal roots and their relationship to intervertebral discs

Origin of lumbar spinal roots and their relationship to intervertebral discs Origin of lumbar spinal roots and their relationship to intervertebral discs A CADAVER AND RADIOLOGICAL STUDY S. W. Suh, V. U. Shingade, S. H. Lee, J. H. Bae, C. E. Park, J. Y. Song From the University

More information

Clinical Consultant, Metabolic Health and Wellness, St. Louis, MO, Present

Clinical Consultant, Metabolic Health and Wellness, St. Louis, MO, Present KYLE LONGO, D.C. 555 N New Ballas Rd., Suite 220 Saint Louis, MO 63141 Phone: (314) 610-3181 Fax: (314) 787-4894 Email: drlongo@empowerhealthstl.com Website: www.empowerhealthstl.com SELECTED OCCUPATIONAL

More information

Spinal Cord Anatomy. Key Points. What is the spine? Areas of the spine: Spinal Cord Anatomy

Spinal Cord Anatomy. Key Points. What is the spine? Areas of the spine: Spinal Cord Anatomy Spinal Cord Anatomy Authors: SCIRE Community Team Reviewed by: Riley Louie, PT Last updated: Sept 21, 2017 This page provides an overview of the structures of the spinal cord and how the spinal cord works.

More information

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Search for: Search Search Icd 10 code for lumbar nerve root compression Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu 1-10-2017 Free, official coding info for 2018 ICD - 10 -CM S32 - includes

More information

2019 COLLECTION TYPE: MIPS CLINICAL QUALITY MEASURES (CQMS) MEASURE TYPE: Patient Reported Outcome High Priority

2019 COLLECTION TYPE: MIPS CLINICAL QUALITY MEASURES (CQMS) MEASURE TYPE: Patient Reported Outcome High Priority Quality ID #460: Average Change in Back Pain Following Lumbar Fusion National Quality Strategy Domain: Person and Caregiver-Centered Experience and Outcomes Meaningful Measure Area: Patient Reported Functional

More information

Evaluation of lumbar decompression with pre-operative and post-operative MR myelogram

Evaluation of lumbar decompression with pre-operative and post-operative MR myelogram ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 15 Number 1 Evaluation of lumbar decompression with pre-operative and post-operative MR myelogram U Deliwala, D Bharat, P Patel Citation U Deliwala,

More information

DISORDERS OF THE SPINE TREATING PHYSICIAN DATA SHEET

DISORDERS OF THE SPINE TREATING PHYSICIAN DATA SHEET DISORDERS OF THE SPINE TREATING PHYSICIAN DATA SHEET Short form FOR REPRESENTATIVE USE ONLY REPRESENTATIVE S NAME AND ADDRESS REPRESENTATIVE S TELEPHONE REPRESENTATIVE S EMAIL PHYSICIAN S NAME AND ADDRESS

More information