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Lee, Sohn, Kim, and Lee: Significance of Space-Occupying Ratio According to MRI Finding in Lumbar Disc Herniation
Original Article

Journal of Korean Spine Surg 2002;9(1):14-18.

Published online: 21 February 2002

DOI: https://doi.org/10.4184/jkss.2002.9.1.14

Significance of Space-Occupying Ratio According to MRI Finding in Lumbar Disc Herniation

Kyu Yeol Lee, M.D., Sung Keun Sohn, M.D., Chul Hong Kim, M.D., Jae Won Lee, M.D.

Department of Orthopaedic Surgery, College of Medicine, Dong-A University, Busan, Korea

Address reprint requests to Kyu Yeol Lee, M.D. Department of Orthopaedic Surgery, College of Medicine, Dong-A Univ.3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Korea Tel : 82-51-240-2867, Fax : 82-51-243-9764, E-mail : gylee@mail.donga.ac.kr

Copyright © 2002 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study design

Clinical significance of spaceoccupying ratio according to MRI finding in lumbar disc herniation.

Objectives

To estimate relationship between patient's symptoms and spaceoccupying ratio in herniated lumbar vertebral disc in MRI according to JOA scoring system.

Summary of literature review

Using MRI, herniated intervertebral disc may be estimated with the extent of derangement of the constituents of the disc. Symptoms and signs did not correlate with the degree of reduction of the herniation in MRI.

Material and Method

A retrospective analysis was performed upon 99 patients that underwent lumbar spine MRI. The degree of the occupied spinal canal was measured by ‘Space- occupying ratio’, which was the ratio of the longitudinal diameter at the spinal canal to the longitudinal diameter at the herniated nucleus purposus. Each ‘30% Space- occupying ratio’ to ‘50% Space-occupying ratio’ was classified to analysis I, analysis II. Under the percent was group A, above the percent was group B. We estimate the patient's condition related with lower back pain according to JOA scoring system.

Results

The herniation type of the nucleus purposus was classified to 5 protruded type, 62 subligamentous extruded type, 22 transligamentous extruded type, 10 sequestral type. The patients who have above 30% were 62 cases, under 30% were 26 cases in analysis I, have above 50% were 19 cases, under 50% were 69 cases in analysis II. So, there was not distinguished from analysis I to analysis II according to the degree of the herniation. Mean JOA score was 9.307 in group A, mean JOA score was 9.370 in group B in analysis I. Mean JOA score was 9.391 in group A, mean JOA score was 9.315 in group B in analysisⅡ. There was not correlate statistically with analysisⅠ(p value=0.5669) and analysis II(p value=0.5390) using the Wilcoxon score test.

Conclusion

There was not correlate statistically with the degree of the herniation in lumbar spine MRI according to JOA scoring system.

Keywords: Space- occupying ratio, MRI, lumbar HNP

REFERENCES

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Figures and Tables%

Fig. 1.
Measurement method for spaceoccupying ratio Fig. 1. The spaceoccupying ratio of the herniated material to the spinal canal, Fig. 1. A/B(spaceoccupying ratio)× 100(%) on axial images, was calculated
jkss-9-14f1.tif
Table 1.
Involved spine level.
Level No. of Patients
L1,2 1(1%)
L2,3 5(5%)
L3,4 3(3%)
L4,5 57(57.5%)
L4,5,S1 6(6%)
L5,S1 25(25.2%)
L5,6 2(2%)
Table 2.
JOA(Japanese Orthopaedic Association) scoring system.
1. Subjective symptoms(9 points)
A. Low back pain
A. Norma(3), Occasional mild pain(2), Frequent mild or occasional severe pain(1), Frequent or continuous severe pain(0)l
B. Leg pain and/or tingling
A. Normal(3), Occasional slight symptoms(2), Frequent slight or occasional severe symptom(1), Frequent or continuous severe symptom(0)
symptom(0) C. Gait
A. Normal(3)
A. Able to walk farther than 500 M although it results in pain, tingling, and/or muscle weakness(2)
A. Unable to walk farther than 500 M although it results in pain, tingling, and/or muscle weakness(1)
A. Unable to walk farther than 100 M although it results in pain, tingling, and/or muscle weakness(0)
2. Clinical signs(6 points)
A. Straight leg-raising tests(SLR)(including tight hamstring)
A. Normal(2), 30-70 degree(1), less than 30 degree(0)
B. Sensory disturbance
A. None(2), slight disturbance(not subjective)(1), marked disturbance(0)
C. Motor disturbance(MMT)
A. Normal(Grade 5)(2), slight weakness(Grade4)(1), marked weakness(Grade3-0)(0)
3. Urinary Bladder Function(-6 points)
A. Normal(0), mild dysuria(-3), severe dysuria(-6)
Table 3.
Analysis of the herniated disc type according to the spaceoccupying ratio.
Group A(30%↓) Guoup B(30%↑)
Protruded 3 2
Subligamentous extruded 8 56
Transligamentous extruded 2 22
Sequestral 2 4
Group A(50%↓) Guoup B(50%↑)
Protruded 4 1
Subligamentous extruded 30 34
Transligamentous extruded 9 15
Sequestral 6 0
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