Imaging studies.Discography consists of injecting contrast medium in the disk.Reproduction of pain similar to the previous one is suggesting that the source disc. Evaluate the anatomical changes of the disc.Lumbar radiograph is a simple routine for every patient suspected of having herniated disc. This investigation assesses the face and joints, vertebral foramen, intervertebral spaces and protrusion of the nucleus.
Full myelography computed tomography scan is the imaging test of choice for evaluating spinal stenosis and the foramen.Myelography without anatomical information in evaluating a herniated disc. It is useful to visualize the nerve roots. CT scan with or without intrathecal contrast is used to estimate the channel diameter. The scan can show the type of hernia, the position of herniated nucleus fragments fiber ring, its cracks, degenerative changes.
MRI is helpful in diagnosing lumbar discopathies. Has advantages such as direct imaging in multiple planes, better define the neural elements, increased accuracy in the evaluation of spinal marrow diseases intrinsic neinvazivitatea, myelogram similar images.
Electromyography is useful in evaluating radiculopatiei caused by degeneration, but is of limited value in evaluating myelopathy.Somatosensory evoked potential responses in myelopathy are Late or small amplitude. Cortical motor evoked potentials are more sensitive than those somatomotorii in evaluating spinal cord dysfunction. As a measure invasive cervical discography is not routinely used in evaluating the degenerative disease.
Histological examination.Biochemically, aging increases the rate of keratin sulfate to chondroitin sulfate, and modifying the proportion of condritin 4-sulfate and chondroitin 6-sulfate compared with concomitant loss of water. Decreases synthesis of proteoglycans, subtracting osmotic swelling and trafficking of oxygen and nutrients. Because stopping the intake of nutrients to the disc and protein metabolic products in stagnant noncolagene disk. Nonenzimatica glycosylation of these metabolites cause yellowing of the disc.The differential diagnosis is made with the following conditions: stretching the muscle and tendon injuries ligementelor syndrome, sacroiliac joint, hip pain, compression fracture, spondylosis, spondiloartropatia, Marfan syndrome, fibromyalgia, pain miofasciala, dIschia, neoplastic disease.
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