Assessment of the Possibilities of B-Mode Ultrasonography in the Diagnosis of Lumbar Intervertebral Discs Protrusion in Adolescents

Rizvan Ya Abdullaiev, Ilgar G Mammadov, Tatyana A Dudnik, Roman R Abdullaiev

Abstract


Objective: To improve the efficiency of lumbar intervertebral discs protrusion by determining the ultrasound biomarkers. Materials and Methods: The study included 68 patients with the disc protrusion and 65 healthy adolescents with normal lumbar intervertebral discs and neurologic status aged 16-18 years. Ultrasonography (USG) was performed at the level of disks L1-L2, L2-L3, L3-L4, L4-L5, L5-S1 in longitudinal and transverse projections. In longitudinal section was measured height of lumbar vertebrae and intervertebral discs, in axial section – the sagittal sizes of intervertebral discs and spinal canal, width of spinal nerve canals, thickness of the yellow ligament. Results: In 31 (45,6±6,0%) cases the protrusion was paramedian, in 16 (23,5±5,1%) – posterolateral, in 13 (19,1±4,8) – median and in 8 (11,8±3,9%) – circular types. The paramedian protrusion was significantly more frequently recorded than the posterolateral (P<0,05), median and circular (p <0.001) types. In 7 (10,3±3,7% ) cases the protrusion was localized at the level of L2-L3, in 13 (19,1 ±4,8%) – L3-L4, in 27 (39,7±5,9%) - at the level of L4-L5 and in 21 (30,9±5,6%) – at the level of L5-S1 respectively. There were no significant differences in the frequency of occurrence between L2-L3 and L3-L4, as well as L4-L5 and L5-S1. The lower located lumbar discs were significantly more affected than the upper ones (P<0,05; P<0,001).Conclusions: In adolescents in the lumbar spine, paramedian protrusion are most commonly found, which are most often localized at the level of both L4-L5 and L5-S1. The greatest  narrowing and deformation of the spinal nerve canal is observed by posterolateral and paramedian protrusion. The greatest thickness of the yellow ligament, radiculopathy  is observed at level of L5-S1 protrusion. 


Keywords


Lumbar Intervertebral Discs Protrusion, Spinal Canal, Ultrasound Diagnostics, Adolescents

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DOI: http://dx.doi.org/10.24294/jpedd.v2i1.146

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