1/11/2024 0 Comments Cracked disk xray lumbar spineThe latter form of extrusion is best further specified or subclassified as sequestration if the displaced disc material has lost continuity completely with the parent disc ( Fig. 6). Extrusion is present when, in at least one plane, any one distance between the edges of the disc material beyond the disc space is greater than the distance between the edges of the base of the disc material beyond the disc space or when no continuity exists between the disc material beyond the disc space and that within the disc space ( Fig. 5). ![]() The base is defined as the width of disc material at the outer margin of the disc space of origin, where disc material displaced beyond the disc space is continuous with the disc material within the disc space ( Fig. 4). Protrusion is present if the greatest distance between the edges of the disc material presenting outside the disc space is less than the distance between the edges of the base of that disc material extending outside the disc space. Relatively wide annular fissures, with stretch of the residual annular margin, at times including avulsion of an annular fragment, have sometimes been called ‘‘annular gaps,’’ a term that is relatively new and not accepted as standard [ A ‘‘transverse fissure’’ is a horizontally oriented radial fissure, but the term is sometimes used in a narrower sense to refer to a horizontally oriented fissure limited to the peripheral annulus that may include separation of annular fibers from the apophyseal bone. A ‘‘radial fissure’’ is a vertically, horizontally, or obliquely oriented separation of (or rent in) annular fibers that extends from the nucleus peripherally to or through the annulus. A ‘‘concentric fissure’’ is a separation or delamination of annular fibers parallel to the peripheral contour of the disc ( Fig. 2). Fissures are sometimes classified by their orientation. Introduction and historyĪnnular fissures are separations between the annular fibers or separations of annular fibers from their attachments to the vertebral bone. This revision will update a workable standard nomenclature, accepted and used universally by imaging and clinical physicians. Several other minor amendments have been made. The modifications deal primarily with the following: updating and expansion of Text, Glossary, and References to meet contemporary needs revision of Figures to provide greater clarity emphasis of the term ‘‘annular fissure’’ in place of ‘‘annular tear’’ refinement of the definitions of ‘‘acute’’ and ‘‘chronic’’ disc herniations revision of the distinction between disc herniation and asymmetrically bulging disc elimination of the Tables in favor of greater clarity from the revised Text and Figures and deletion of the section of Reporting and Coding because of frequent changes in those practices, which are best addressed by other publications. ![]() This revised document preserves the format and most of the language of the original, with changes consistent with current concepts in radiologic and clinical care. Responding to an initiative from the ASSR, a task force of spine physicians from the ASSR, ASNR, and NASS has reviewed and modified the document. This document has passed the test of time. ![]() This article reflects changes consistent with current concepts in radiologic and clinical care. The revised document is presented here, and it represents the consensus recommendations of contemporary combined task forces of the ASSR, ASNR, and NASS. Since 2001, there has been sufficient evolution in our understanding of the lumbar disc to suggest the need for revision and updating of the original document. Its purpose was to promote greater clarity and consistency of usage of spinal terminology, and it has served this purpose well for over a decade. It was authored by David Fardon, MD, and Pierre Milette, MD, and formally endorsed by the American Society of Spine Radiology (ASSR), American Society of Neuroradiology (ASNR), and North American Spine Society (NASS). The paper ‘‘Nomenclature and classification of lumbar disc pathology, recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology,’’ was published in 2001 in Spine (© Lippincott, Williams & Wilkins).
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