Readers Mr. Wang asked: My father often feels low back pain recently. I suspect that it is a herniated lumbar intervertebral disc. What is the best way to first check the lumbar spine? What are the differences between X-ray, CT, and magnetic resonance imaging (MRI)?
Wang Zhenhu, MD, director of joint surgery of the No. 252 Hospital of the People's Liberation Army, answered: Whether or not lumbar vertebral surgery needs imaging examinations, how to choose the examination method should be determined according to the specific conditions. 1. The symptoms are short, low back pain and other symptoms are mild, if the doctor thinks Medical history is clear, diagnosis is clear, imaging examination is not required, functional exercise, physical therapy, internal or topical medication can be used to reduce radiation damage. 2. Long duration, typical symptoms, such as low back pain with lower extremity radiating pain, numbness, muscle atrophy In other patients, if the doctor believes that there is a possibility of nerve root compression, it is recommended to perform X-ray of the lumbar spine (positive lateral position, hyperextensional flexion) and MRI examination to evaluate the bony structural stability of the lumbar spine and to understand the degree of nerve compression. 3. Low back pain combined with lower limb weakness, pain, numbness, difficulties in walking, 'stepping on cotton', chest and abdomen banding, if the symptoms increase rapidly in the short term, the high nerves above the waist should be excluded (such as brain Stem, neck, thoracic disc herniation, ligamentum flavum, calcification of posterior longitudinal ligament, compression of the spinal cord in the spinal canal, etc.), preferred MRI, can clearly show the extent of spinal nerve compression. The advantage of CT is in distinguishing the vertebral body, pedicle, and articular process, but it cannot be clearly shown in the soft tissues such as intervertebral disc or nerve root.
