INTERVERTEBRAL DISC CHARACTERISTIC ON PROGRESSIVE NEUROLOGICAL DEFICIT
ABSTRACT: To examine the
intervertebral disc characteristic on magnetic resonance imaging (MRI) in
lumbar herniated disc (LHD) patients with progressive neurological deficit.
Methods: Patients were collected retrospectively from Dr. Hasan Sadikin
General Hospital Database from 2011–2013 with LHD, had neurological deficit
such as radiculopathy and cauda equine syndrome for less than four weeks with a
positive sign confirmed by neurological examination and confirmatory with MRI
examination.
Results: A total of 14 patients with lumbar herniated disc disease (10
males, 4 females) suffered from progressive neurological deficit with an
average age of (52.07±10.9) years old. Early disc height was 9.38±0.5 mm and
progressive neurological deficit state disc height was 4.03±0.53 mm, which were
significantly different statisticaly (p<0.01). Symptoms of radiculopathy
were seen in 11 patients and cauda equine syndrome in three patients. Modic
changes grade 1 was found in five patients, grade 2 in eight patients,grade 3
in one patient, Pfirmman grade 2 in eleven patients and grade 3 in three
patients. Thecal sac compression 1/3 compression was seen in four patients and
2/3 compression in ten patients.
Conclusions: Neurosurgeon should raise concerns on the characteristic
changes of intervertebral disc in magnetic resonance imaging examination to
avoid further neural injury in lumbar herniated disc patients.
Keywords: Lumbar herniated
disc, magnetic resonance imaging, progressive neurological deficit
Penulis: Farid Yudoyono, Rully
Hanafi Dahlan, Muhammad Zafrullah Arifin
Kode Jurnal: jpkedokterandd170276
