Imaging Analysis Of Recoverability Of Nucleus Pulposus In Patients With Lumbar Disc Hemiation Under CT Monitoring

Objective: To evaluate whether the protrude nucleus pulposus has recoverability as well as the function of traction for the patients with lumbar disc hemiation received conservative treatment. 30 patients with lumbar disc hemiation were scaned using CT under pre-traction stress static condition,traction stress condition and post-traction static condition,to observe the image changes of the protrude nucleus pulposus under the three different conditions. Method :Using CT-matched traction device to carry out longitudinal traction on spinal column of the patients with confirmed lumbar disc hemiation by tractive stress of 1/2 patient's weight for 5 minutes. Taking 5 mm multiplanes scannings and photographs of lumbar vertebra under pre-traction stress static condition(PRT),traction stress condition(UNT) and post-traction stress static condition(POT) under CT monitoring. Then processing and analysising the different scannings and photographs by computer,using variance analysis method to make comparison with the obtained values.Result :1.Under PRT compared with UNT,the protrude intercalate disc area decreased,the cross section area of vertebral canalincreased,and the intervertebral space widen (p<0.01).2.Under POT compared with UNT, the protrude intercalate disc area increased,the cross section area of vertebral canal decreased,and the intervertebral space narrowing. It is the result of elastic resilience of intercalated disc tissue and surrounding soft tissue of spinal column relieved from traction condition.3.Under POT compared with PRT, the protrude intercalate disc area decreased,the cross section area of vertebral canal increased,and the intervertebral space widen.It means that elastic resilience of intercalated disc tissue and surrounding soft tissue of spinal column counterbalanced part of the effect of traction.But compared to PRT,there is a significant difference which means there is a definite function of traction. Traction has a definite function in facilitating the protrude nucleus pulposus repositioning.The protrude nucleus pulposus has recoverability under controlled condition.According to the degree of the decrements of the protrude intercalate disc,the recoverability of nucleus pulposus can be divided into three degrees as perfect(decreased>10 mm2), good(decreased 5-10 mm2) and bad(decreased <5 mm2).There are 9 perfect cases,16 good cases,5bad cases in all the 30 patients.Conclusion: The protrude nucleus pulposus has recoverability under traction stress condition in lumbar disc hemiation patients,but the degree of recoverability has differences.It has confirmed the function of traction in the treatment of lumbar disc hemiation,and provided the objective evidence for it in imageology.Acorrding to the results,we proposed the presumptions as follows:if we can make CT monitoring of recoverability as a routine detection method,we can take the degree of recoverability as a objective criteria to make an option between surgical operation and conservative treatment.It deserved further research and observation to see whether it has clinical significance.