ULTRASONOGRAPHIC AND MORPHOLOGIC COMPARISONS OF DEGENERATIVE DISEASES OF LUMBAR SPINE
Objectives of the work was the study and the comparison of utrasonographic data and the results of morphologic investigations of the structural changes of the intervertebral disc (IVD) among the patients with degenerative disease of the lumbar spine. Materials and methods. Utrasonographic and standard X-ray examination of 128 persons have been realized; 83 patients have been undergone by MRI and 33 patients have been undergone by CT. Operative therapies of 24 patients, among whom were 12 men and 12 women, have been performed. Results. Patients were divided into groups depending on localization of the degenerative process in the IVD to systematize ultrasonic criteria. In the first group (with the degenerative changes within the nucleus pulposus, 23 persons, 115 IVD) - changes in the nucleus pulposus have been detected in 47 IVD (40.8 %). In the second group (with the degenerative changes in the nucleus pulposus and in the fibrous ring without disturbance of the integrity of the fibrous ring, 53 persons, 265 IVD) - changes in the nucleus pulposus and fibrous ring have been determined in 198 IVD (75 %). In the third group (with the degenerative changes in the IVD and the disturbance of the integrity of the fibrous ring and involving the elements of the spinal canal in the pathological process, 52 persons, 260 IVD) - patients’ disks were at various stages of lesion of the degenerative processes, changes have been found in 232 IVD (89.2 %). As a consequence of the comparison of the results of the surgical interventions and the US and MRI data in the diagnosis of hernias of the intervertebral disc, indicators of the diagnostic value of each method have been obtained. Conclusions. Realized utrasonographic and morphologic comparisons have proved an accuracy of the ultrasonography data in the diagnosis of hernias of the intervertebral disc: sensitivity - 89.2 %; specificity - 66.6 %; accuracy - 87.1 %. Systematization of ultrasonic signs of osteochondrosis in the intervertebral discs can improve the clinical and topical diagnosis, and also contributes to reducing diagnostic mistakes and conducting appropriate therapeutic and prophylactic measures.