There are various diseases with low back and leg pain. In other words, it is not correct to approach every patient with low back and leg pain with the preconception that “It is definitely a herniated disc”. There are many diseases that mimic lumbar hernia. Many diseases, from a simple sports injury to rheumatism, from infectious diseases to cancer and lumbar slip, can progress with low back and/or leg pain. For this reason, first of all, what the diagnosis is should be clearly revealed. Because the way to success in treatment passes through the correct diagnosis first of all. For this, it is necessary to apply to the relevant specialist doctor. The physician will listen to the patient’s complaints, perform the examination and request all tests and analyzes related to the disease.
The importance of plain X-ray films in the investigation of low back pain has decreased today. This technique, which exposes the patient to radiation, is preferred only in certain situations. The technique of filming (myelography) is also used less and less after an injection is made from the waist and contrast material is injected inside. Because today, imaging techniques have advanced a lot and it has come to a level where there is no need for an injection from the patient’s waist anymore. In fact, the introduction of nonionic contrast agents into the field of use has greatly reduced the side effects of the needle technique. However, it is useful to stay away from myelography as much as possible, since the needle technique itself can have its own side effects. Instead, strong magnetic resonance devices should be preferred.
The examination method called EMG is also useful in the diagnosis and differential diagnosis of herniated disc. Because with this method, it can be revealed whether the disorders in the patient belong to the nervous tissue or the muscle tissue, and it can be differentiated from other diseases from lumbar hernia. It also gives an idea about whether there is damage to the nerves under pressure and the degree of damage, if any. In some cases, this technique may even affect the surgeon’s decision to operate.
In a patient with low back and/or leg pain, advanced examination methods such as computed tomography and usually magnetic resonance are sometimes used.
Magnetic resonance imaging method provides great convenience in diagnosis and differential diagnosis. In addition, the patient does not receive x-rays and superior imaging ability in various plans; The ability to clearly visualize the spinal cord, nerves and other soft tissues makes magnetic resonance increasingly prominent.
However, considering that computed tomography provides better images in pathologies related to bone tissue, both diagnostic methods can be used together in some cases.
Although magnetic resonance is such a useful method, evaluating the obtained images requires a great deal of experience. Misinterpretations lead to wrong treatment methods. If mild disc bulging, which we frequently see, is interpreted as a herniated disc, the treatment may go in a completely different direction.
Interpretation of images obtained from shots taken especially in the postoperative period requires experience. The findings of the examination and the results obtained from the examinations will be evaluated together in a meticulous manner and treatment will be started after a clear diagnosis is reached. Sometimes it can be misleading to decide on surgery because a herniated disc was detected in magnetic resonance imaging. Obtained images must be supported by clinical findings and harmony must be sought between them. If there is no compliance, this should be explained.
Sometimes, bone scintigraphy may be required to make the differential diagnosis of herniated disc and some other vital diseases.
Bone density measurements can also be used to get an idea about the strength and density of bones and to confirm the diagnosis of osteoporosis. Blood and urine analysis can be done for differential diagnosis. As a result of the examination, examination and analysis, it will be clearly revealed whether the patient has a herniated disc and at what stage it is. In other words, it is not enough to be diagnosed with a herniated disc. It is also necessary to determine the stage of the disease. Because the form of treatment will change accordingly. Some patients experience great distress and discomfort when they enter narrow spaces. Open type magnetic resonance devices have been developed for these people. In addition, the examinations of these patients can be performed by taking the necessary precautions in classical type devices. Today, technology has advanced so much that some newly developed open-type magnetic resonance devices can take shots even in upright positions, and thus additional data can be obtained about the patient. |
A great progress has been made in diagnosis with magnetic resonance imaging method.
