Resorption of a herniated disc. Stages of development and associated visual "effects" in MRI diagnosis

Congress:

ECR 2020

Poster Number:

C-11869

Type:

Scientific Exhibit

Keywords:

Multicentre study, Diagnostic or prognostic study, Retrospective, Hernia, Treatment effects, Diagnostic procedure, MR, Musculoskeletal system, Musculoskeletal spine, Musculoskeletal

Authors:

A. Smirnova¹, A. Tkachev², D. Archakov², A. Epifanov³, N. Plakhotina⁴; ¹St. Petersburg/RU, ²Volgograd/RU, ³Samara/RU, ⁴Saint-Petersburg/RU

DOI:

10.26044/ecr2020/C-11869

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-11869

Fig. 1: Male 45 years old. Observation for 6 months. Before resorption of the disc...

Fig. 2: Male 31 years old. Observation for 1 year. Herniated disc L5/S1. There is a...

Fig. 3: Woman 32 years old. Observation for 9 months. Herniated disc C5/C6. There is a...

Purpose

To systematize ideas about the stages of herniated discs resorption, to assess the possibility of developing effects associated with resorption.

Methods and materials

Retrospectively, between 2014 and 2019, the study involved 327 patients with cervical and lumbar spine hernias, which, as a result of conservative treatment without NSAIDs or without any therapy, decreased in size by more than 50%. Studies were performed on 1.5 and 3.0 T tomographs using T1, T2, T2 STIR sequences in three planes with a slice thickness of 3 mm, without the distance between the slices. The number of studies in patients ranged from 3 to 9, depending on the rate of the hernia"...

Results

It was revealed that in 285 (87%) patients before the onset of resorption, an increase in the size of hernial protrusion was recorded, which in 266 (93%) cases was accompanied by an increase in the signal on T2 WI. At the same time, there was an increase the signal from the intervertebral disc itself in 233 (82%) cases. In 195 (60%) patients from all observations there was a partial recovery of the intervertebral disc height, but not more than 2 mm. Also, one of the...

Conclusion

Resorption of a herniated disc has a stepwise course. The first phase is an increase in the size of the herniated disc with a change in its structure, probably due to rehydration caused by an inflammatory reaction. The second phase consists in a gradual decrease in the size of the hernia and may be accompanied by a change in the signal characteristics of the degeneratively altered intervertebral disc, an increase in its height, as well as the restoration of the statics of the vertebral column.

Personal information and conflict of interest

A. V. Smirnova; St. Petersburg/RU - Author at MIBS - Speaker at MIBS A. Tkachev; Volgograd/RU - Consultant at MIBS D. Archakov; Volgograd/RU - Consultant at KTE A. Epifanov; Samara/RU - Consultant at KTE N. Plakhotina; Saint-Petersburg/RU - Employee at MIBS

References

1. Brinjikji W, Luetmer PH, Comstock B et al. Systematic literature review of imaging features of spinal degeneration inasymptomatic populations. AJNR Am J Neu roradiol 2 0 1 5 ; 3 6 (4 ): 8 1 1 –6. 2. Autio RA, Karppinen J, Niinimäki J et al. Determinants of spontaneous resorption of intervertebral disc herniations. Spine 2 0 0 6 ; 3 1 : 1 2 4 7 –5. 3. Tkachev A.M., Akarachkova E.S., Smirnova A.V. et al. Spontaneous regression of herniated discs of the...