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Lumbar Degenerative Disease:Key for Diagnosis Takao YASUHARA 1 , Susumu SASADA 1 , Isao DATE 1 1Department of Neurological Surgery, Okayama University Graduate School of Medicine Keyword: 画像診断 , 神経診察 , 脊柱アラインメント , 腰椎椎間板ヘルニア , 腰部脊柱管狭窄症 , diagnostic imaging , neurological examination , spinal alignment , lumbar herniation , lumbar spinal stenosis pp.1233-1245
Published Date 2021/11/10
DOI https://doi.org/10.11477/mf.1436204510
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 Accurate diagnosis is important for lumbar degenerative diseases. Patients' history, neurological examination, and diagnostic imaging are the three pillars for accurate diagnosis. While collecting medical history, 5W1H of the symptoms should be considered. Muscle strength, pain and numbness, and deep tendon reflex are the basic parameters in the neurological examination. A combination of the results of each tool is needed to facilitate precise diagnosis. This should be followed by diagnostic imaging to confirm the diagnosis. We feel relieved when neurological examination and diagnostic imaging reveals congruent results. The symptoms of lumbar degenerative diseases are the results of[static factors: the stenosis of the canal/intervertebral foramen]×[dynamic factor: the instability]. The T2-weighted MRI images effectively reveal canal/intervertebral foramen stenosis. Short-T1 inversion recovery(STIR)of MRI reveals early fractures and inflammation of the spine. CT findings help to imagine the process of drilling and screw insertion. A whole spine X-ray is good to reveal spinal alignment. Roentogenkymography with anteflexion/retroflexion reveals the instability of the lumbar spine. Myelography is effective in knowing the cerebrospinal fluid flow in a standing position. Therefore, accurate diagnosis and careful treatment are needed to obtain the appropriate outcome for a prolonged period after spinal surgery.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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