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X-ray of Bertolotti's syndrome (in this case, right transverse mega-apophysis of L5 with pseudoarticulation with the sacral ala). Woman 67 years old. Bertolotti's syndrome is a commonly missed cause of back pain which occurs due to lumbosacral transitional vertebrae (LSTV).
Historically the procedure involved the injection of a radiocontrast agent into the cervical or lumbar spine, followed by several X-ray projections. Today, myelography has largely been replaced by the use of MRI scans , although the technique is still sometimes used under certain circumstances – though now usually in conjunction with CT ...
Lumbosacral transitional vertebrae consist of the process of the last lumbar vertebra fusing with the first sacral segment. [1] While only around 10 percent of adults have a spinal abnormality due to genetics, a sixth lumbar vertebra is one of the more common abnormalities. [2] Sacralization of the L5 vertebra is seen at the lower right of the ...
These cannot be determined by plain films, as the x-ray passes through the soft tissue. A study by Giles et al., stated that sixteen of the thirty patients (53%) had retrolisthesis of L5 on S1 ranging from 2–9 mm; these patients had either intervertebral disc bulging or protrusion on CT examination ranging from 3–7 mm into the spinal canal.
In some, the x-ray findings may correspond to symptoms of back stiffness with flexion/extension or with mild back pain. [2] Back pain or stiffness may be worse in the morning. [ 4 ] Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain , difficulty swallowing [ 5 ] [ 6 ] or even dyspnea . [ 7 ]
The lumbosacral ligament or lateral lumbosacral ligament is a ligament that helps to stabilise the lumbosacral joint. The ligament's medial attachment is at (the inferior border of) transverse process of lumbar vertebra L5; its lateral attachment is at the ala of sacrum .
Relative stenosis is said to exist when the anterior-posterior canal diameter measures between 10 and 13 mm. Absolute stenosis of the lumbar canal exists anatomically when the anterior-posterior measurement is 10 mm or less. [12] [13] [14] Plain X-rays of the lumbar or cervical spine may or may not show spinal stenosis.
Lumbar provocative discography (also referred to as "discography" or discogram) is an invasive diagnostic procedure for evaluation for intervertebral disc pathology. It is usually reserved for persons with persistent, severe low back pain (LBP) who have abnormal spaces between vertebrae on magnetic resonance imaging (MRI), where other diagnostic tests have failed to reveal clear confirmation ...