Free Disc Fragment : A Retrospective Case Analysist

ART ARTHORNTHURASOOK, M.D.*, RASMI WANISSORN, M.D., D.Sc.**

Affiliation : * Department of Orthopaedic Surgery, ** Department of Neurosurgery, Siam General Hospital, Bangkok, 10230, Thailand. t Presented at the 20th Annual Meeting of the Royal College of Orthopaedic Surgeons of Thailand and the Thai Orthopaedic Association on October 21-24, 1998.

AbstractPreoperative diagnosis of free disc fragment is important in order to avoid treatment by chymopapain and percutaneous method of disc removal or anterior discectomy. This retrospective case analysis was to study the cause, physical findings and appropriate investigation to identify free disc fragment before surgery. One hundred and thirteen operative patients of herniated lumbar disc were studied. Of these, eleven patients (9.7%) were diagnosed with free disc frag- ment. The results revealed that one patient was diagnosed preoperatively with free disc fragment by myelography and MRI and three other patients using MRI alone. We concluded that pre- operative diagnosis of free disc fragment can be made through identification of a large myelo- graphic defect and/or sagittal scan MRI showing migration of disc material from native disc space.

Keywords : Free Disc Fragment, Herniated Lumbar Disc

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