Clinical Significance of Protrusion Edge Enhancement Using Contrast-Enhanced Magnetic Resonance Imaging in The Conservative Treatment of Giant Lumbar Disc Herniation: A Prospective Observational Study [post]

Zhijia Ma, Pengfei Yu, Yuxiang Dai, Qiuxiang Feng, Hong Jiang, Xiaochun Li, Zhenhan Yu, Jin Tao Liu
2020 unpublished
Background: Contrast-enhanced lumbar spine magnetic resonance imaging (MRI) was used to predict the efficacy of conservative treatment of giant lumbar disc herniation.Methods: From June 2017 to June 2019, 30 patients with giant lumbar disc herniation with positive and negative bull's eye signs on contrast-enhanced lumbar spine MRI were assessed to measure differences in the rate of intervertebral disc herniation, rate of protrusion absorption, treatment effect, protrusion rate, and curative
more » ... e, and curative effect according to the lumbar Japanese Orthopedic Association (JOA) score before and after treatment.Results: Thirty patients with positive and negative bull's eye signs (36 men and 24 women) aged 19 to 58 years (mean, 36.37 ± 9.56 years) were included. All patients were followed up for more than 1 year, and at least one MRI review was conducted within 1 year of treatment. The results of the first and final MRI examinations were compared. The protrusion rate was 82.16% ± 14.58% before treatment and 32.20% ± 30.80% after treatment, and the absorptivity of the protrusion was 59.48% ± 38.62%. There was no statistically significant difference in the general data before treatment between the positive and negative groups (P > 0.05). After treatment, the protrusion rate in the positive and negative bull's eye sign groups was 14.41% ± 14.37% and 49.99% ± 32.70%, respectively (P < 0.05). The absorptivity in the positive and negative bull's eye sign groups was 83.09% ± 15.54% and 35.87% ± 40.49%, respectively (P < 0.05). There was no statistically significant difference in the JOA score between the two groups before treatment (P > 0.05); however, there was a statistically significant difference in the JOA score between the two groups at 3 months (P < 0.05) and 1 year (P < 0.05) after treatment.Conclusions: Conservative treatment of giant lumbar disc herniation has a satisfactory clinical effect. Contrast-enhanced MRI can be used to predict the resorption of giant lumbar disc herniation. Protrusion resorption is more likely to occur in patients with than without a bull's eye sign.Trial registration: Chinese Clinical Trial Registry (No. ChiCTR1900022377). Retrospectively registered 08 April 2019.
doi:10.21203/rs.3.rs-124232/v1 fatcat:gn2mninhjzcr7mxukztzmjl7ie