LINKS:
Doug's Current Treatment Diary:
Tutorials:
MRI / CT - Axial Anatomy + Disc bulge & Herniation:
Basic Anatomy of the Lumbar Disc:
Disc Herniation - How it evolves:
Disc Herniation continued: Pain!
RESEARCH:
Disc Herniation & Radiculopathy Facts:
Pathophysiology of Degenerative Disc Disease:
IMAGES:
MRI - Cervical Anatomy & axial post ACDF:
MRI/CT Axial Anatomy:
Disc Bulge & Herniation:
The Disc bulge:
First a warning. MRI's and CT scans are hard to read at first but after some practice you will start to 'hallucinate things' with the best of us. The first day of X-Ray pathology our instructor said in order to be good at reading X-ray, MRI, CT you have to have a good imagination!
Here we have a CT Axial View of a typical Disc Bulge. I have gave you a 'unlabeled' picture on the left and then the labeled picture on the right.
Notice how the whole back of the disc bulges backwards into the spinal canal past the margin of the endplate. This 'broad based expansion' is the Key in identifying the disc bulge. These are occasionally seen in asymptomatic people BUT they are often associated with degenerative disc disease (DDD). If this is the case, then its only a matter of time before this bulge turns into a small contained disc Herniation (aka:Protrusion).
The Disc Herniation (AKA: Protrusion)
Here we have a CT Axial View of a your typical small contained Disc Herniation. Now you will appreciate the difference from the disc bulge above. In stead of a broad gentle expansion of the back (posterior) of the disc, we have a much more pointed appearance and much more encroachment (smashing) into the right lateral recess. the spinal cord (or Cauda Equina as its called at this level) does not show up well for no contract material has been injected but you can see 'hallucinate' or 'imagine' that the cord is more than contacted.
