Herniated material may be contained by the posterior longitudinal ligament (PLL) or be accompanied by a PLL tear. In total, 90% of discs improve clinically with 8-10 weeks of symptomatic treatment, 50% improve on MRI and 10% get worse.

•  Axial and sagittal T2 and T1 slices are key to diagnosis.
•  Look for disc material herniating into the canal, lateral recess or exit foramina.
•  Lateral disc protrusion passes into the exit foramen and compresses the exiting root (symptoms are the same as a central protrusion at the level above).
•  Check for signal change within the cord on T2 (i.e. cord compression).
•  Check for associated facet joint degeneration and thickening of the ligamentum flavum.
•  Sequestrated fragments may migrate caudally/cranially/become intradural.
•  Sequestered fragments may become surrounded by granulation tissue and enhance with contrast.
•  Post-operatively, look for non-enhancing disc material (recurrence); enhancement of disc material suggests fibrosis and scarring.


Leave a Comment

Your email address will not be published.

Scroll to Top