Download Free Medical Disc prolapse and degenerative changes PowerPoint Presentation

Disc prolapse and degenerative changes PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Radiology and Imaging, which is titled "Disc prolapse and degenerative changes", to know about disc prolapse and degenerative changes.

Tags : Radiology, Imaging, Disc prolapse, degenerative changes

Published on : Aug 02, 2021 | Views : 2512 | Downloads : 5

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

DISC PROLAPSE AND DEGENERATIVE CHANGES
Slide 2-

Intervertebral Discs      Gel like Tissue between each vertebra fibro cartilaginous cushions serve as the spine's shock absorbing system protect the vertebrae, brain, and other structures The discs allow some vertebral motion extension and flexion.
Slide 3-

Intervertebral Discs  The disc is made up of 3 structures the Nucleus pulposus, gelatinous center Annulus Fibrosus. Its job is to contain the nucleus Vertebral end plates that attach the disc to the vertebrae   
Slide 4-

 Process of wear and tear of intervertebral discs, vertebral bodies, and facet joints is called spondylosis  Commonest cause of entrapment spinal neuropathy  Usual age group >60 yrs  Usually asymptomatic
Slide 5-

DISC PROLAPSE  Extrusion of nucleus pulposus through posterior or posteriolateral radial tear in annulus fibrosis
Slide 6-

TYPES Focal herniation is a herniated disc less than 90° of the disc circumference. Broadbased herniation is a herniated disc in between 90°-180° of the disc circumference. Bulging Disc is the presence of disc tissue 'circumferentially' (180°-360°) beyond the edges of the ring apophyses and is not considered a form of herniation
Slide 7-

ppt slide no 7 content not found
Slide 8-

 AXIAL LOCALISATION OF HERNIATED DISCS  Central or medial posterior longitudinal ligament is thickest in this region,disc usually herniates slightly to the left or right of this central zone.  Paramedian or lateral recess PLL is not as thick in this region, this is common region for disc herniations.  Foraminal or subarticular It is rare for a disc to herniate into the intervertebral foramen. 'Dorsal Root Ganglion' lies in this zone resulting in severe pain, sciatica and nerve cell damage.  Extraforaminal or lateral Disc herniations in this region are uncommon.
Slide 9-

ppt slide no 9 content not found
Slide 10-

IMAGING for disc prolapse CT SCAN Disc material is denser than CSF in thecal sac…… so clearly seen against epidural fat BUT, very large extrusion may be missed.
Slide 11-

MRI Extruded fragments brighter on T2 Enhance after contrast Sometimes heavily calcified More reliable in cervical spine where there is less epidural fat
Slide 12-

X-RAYS Non specific findings Reduction of disc space or vertebral mal alignment or normal
Slide 13-

Axial T1-weighted image shows protrusion of a left paracentral disc with compression of left S1 root
Slide 14-

Axial T2-weighted image shows protraction of a left paracentral disc with compression of left S1 root
Slide 15-

CT axial.L3,4 disc space. Soft tissue mass in R. posterolateral aspect of disc encroaching into intervertebral foramen and extending lateral to it.arrow…L3 N
Slide 16-

T1W axial. L4,5 disc, disc fragment extends behind upper part of right side of body of sacrum. Displacing 1st sacral nerve root post and erodes sacral body.
Slide 17-

L5/S1 disc space.low signal mass protruding posteriorly and to the right from the posterior disc margin.This causes only minor compresion on the anterior margin of the theca (the bright, CSF containing sac in the spinal canal). The nerve roots within the theca are visible around its posterolateral margins and are not affected. However the neural foramen on the right is obliterated - compare with the other side where the higher signal fat, and the lower signal S1 nerve root are clearly seen
Slide 18-

Sagittal T2 weighted MRI images of 49-year male with history of radiculopathy. a. Pre-op image showing disc prolapse at C5/6 level. b,c,d are post-op images
Slide 19-

MRI of a patient showing disc prolapse between L5 and S1 vertebra
Slide 20-

DEGENERATIVE CHANGES  osteophytosis & marginal sclerosis  Mostly in lower cervical and lumbar region  reactive changes  Degeneration in ligaments  ossification  calcification
Slide 21-

 these changes occur in  post. longitudinal ligament  cruciform ligament  ligamenta flava  capsular ligament of facet joints
Slide 22-

 Also include  Ossification of post. long. Ligament  Retro-odontoid pseudotumor  Ossification of ligamentum flavum  Synovial cysts
Slide 23-

degenerative changes are seen in  Ochronosis  Charcot spine  Ankylosing spondylitis  Rheumatoid arthritis  Isolated phenomenon
Slide 24-

X-RAYS most of the features of degeneration can be seen If, sagittal diameter of spinal canal in cervical region <10mm…..spinal cord compressed
Slide 25-

CT SCAN / MRI Deformation of spinal & intervertebral canals…CT / MRI Better visualization of neural structures… MRI Differentiation from infection….MRI… absent/ non-uniform high signal, irregularity/fragmentation.
Slide 26-

Sagittal T2W contrast.ossification of post. Longitudnal ligament
Slide 27-

SPINAL STENOSIS Most common in  Achondroplasia  Acromegaly
Slide 28-

CT / MRI Spinal canal is very narrow Cross-sectional area less than 110mm² No CSF signal on T2 weighted image Reduntant coiling of intradural roots above stenosis…on MRI… entrapment of cauda equina
Slide 29-

Sagittal T2W ,with contrast. Stenosis of spinal canal at L4,5. no CSF signal at stenosis
Slide 30-

POST-OPERATIVE CHANGES  Post-op recurrent myelopathy / radiculopathy  2 types  Discogenic  Reactive
Slide 31-

 CT / MRI  Discogenic  Typical mass continuous with disc substance  Reactive  Contracting lesion standing around theca / nerve root, continuing into soft tissue.
Slide 32-

 T2W, disc higher signal than scar  Recent scar enhances faster, old scar less and slowly.
Slide 33-

THANK YOU