Abstract：
BACKGROUND:MRI is the gold standard for evaluating the relationship of disc material to soft tissue and neural structures. However, terminologies used to describe lumbar disc herniation and nerve root compression have always been a source of confusion. A clear understanding of lumbar disc terminology among clinicians, radiologists, and researchers is vital for patient care and future research. QUESTIONS/PURPOSES:Through a systematic review of the literature, the purpose of this article is to describe lumbar disc terminology and comment on the reliability of various nomenclature systems and their application to clinical practice. METHODS:PubMed was used for our literature search using the following MeSH headings: "Magnetic Resonance Imaging and Intervertebral Disc Displacement" and "Lumbar Vertebrae" and terms "nomenclature" or "grading" or "classification". Ten papers evaluating lumbar disc herniation/nerve root compression using different grading criteria and providing information regarding intraobserver and interobserver agreement were identified. RESULTS:To date, the Combined Task Force (CTF) and van Rijn classification systems are the most reliable methods for describing lumbar disc herniation and nerve root compression, respectively. van Rijn dichotomized nerve roots from "definitely no root compression, possibly no root compression, indeterminate root compression, possible root compression, and definite root compression" into no root compression (first three categories) and root compression (last two categories). The CTF classification defines lumbar discs as normal, focal protrusion, broad-based protrusion, or extrusion. The CTF classification system excludes "disc bulges," which is a source of confusion and disagreement among many practitioners. This potentially accounts for its improved reliability compared with other proposed nomenclature systems. CONCLUSIONS:The main issue in the management of patients with lumbar disc disease and nerve root compression is correlation of imaging findings with clinical presentation and symptomatology to guide treatment and intervention. Although it appears that the most commonly supported nomenclatures have strong interobserver reliability, the classification term "disc bulges" is a source of confusion and disagreement among many practitioners. Additional research should focus on the clinical application of the various nomenclatures.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Li Y,Fredrickson V,Resnick DKdoi
10.1007/s11999-014-3674-ysubject
Has Abstractpub_date
2015-06-01 00:00:00pages
1896-902issue
6eissn
0009-921Xissn
1528-1132journal_volume
473pub_type
杂志文章,评审abstract：:Degenerative changes in the spine, specifically disc degeneration and facet arthrosis, and osteoporosis are conditions that primarily affect the elderly and may significantly impact the quality of life. The relationship between osteoporosis and degenerative changes in the hip joint has been studied, but their correlat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199603000-00017
更新日期：1996-03-01 00:00:00
abstract：:For patients with advanced cancer who present with or develop a bone lesion as the only focus of cancer beyond the primary site, en bloc resection of the metastasis may optimize local tumor control, provide durable pain relief, and possibly prolong patient survival. For patients with pelvic metastasis, however, this s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e3180619533
更新日期：2007-06-01 00:00:00
abstract：:One hundred seventy-five patients with 243 consecutive primary Press Fit Condylar cruciate-substituting total knee replacements were evaluated at a mean of 5.5 years. One hundred thirteen knees had modular metal-backed tibial components and 130 had all-polyethylene tibial components. The mean knee score and functional...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200111000-00021
更新日期：2001-11-01 00:00:00
abstract：:The great toe is affected by many congenital and acquired conditions including arthritis, hallux valgus, and hallux rigidus and disease of the hallucal sesamoids. Many surgical procedures have been described for the treatment of these conditions. With the increased popularity of forefoot surgery comes the potential fo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200110000-00008
更新日期：2001-10-01 00:00:00
abstract：:To define radiographic criteria, the radiographs of all patients diagnosed with coxarthrosis during the year 1951 were reviewed. Structural or joint space changes, evident radiographically in one of every seven cases in 1951, persisted at the time of the review in 1962. In the remaining cases, the diagnosis had been b...
journal_title：Clinical orthopaedics and related research
pub_type： 传,古典文章,历史文章,杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：:Removal of cement from the femoral canal during total hip revision arthroplasty continues to be very challenging. The technique is described using multiple 9-mm perforations placed at least 5 cm apart on the anterior surface of the femoral shaft. The tip of the revision stem should be at least 5 cm distal to the most ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:Syndesmosis sprains have received increasing recognition during recent years because of a heightened awareness of the mechanism, symptoms, and signs of injury. Syndesmosis injuries take longer to recover than lateral ankle sprains, and no consensus exists regarding optimal treatment of these injuries. Therefore, we un...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/BLO.0b013e31802eb471
更新日期：2007-02-01 00:00:00
abstract：:Shoulder motion has traditionally been described in reference to arbitrarily defined planes of motion (e.g., sagittal/flexion, coronal/abduction). This study examined shoulder muscle recruitment during conical arm movements, which include all planes of motion. Electromyographic (EMG) data was collected with intramuscu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:Common misconceptions about distal radius fractures result in undertreatment of many fractures, particularly in an active population. Loss of reduction of the fracture may cause a symptomatic malunion. Fourteen patients with an average age of 39 years (range, 21-65 years) underwent reconstructive procedures for radial...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199606000-00021
更新日期：1996-06-01 00:00:00
abstract：:Pigmented villonodular synovitis (PVNS) is an uncommon disorder of the synovium that rarely involves the hip joint. The natural history of an untreated case of PVNS is presented herein. A young adult with a painful hip and destructive changes on plain roentgenograms requires further diagnostic evaluation. The relative...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-02-01 00:00:00
abstract：:Evidence from studies on migration raises serious doubts regarding the part played by fatigue failure of acrylic bone cement in the genesis of aseptic loosening of the components of total hip arthroplasties. Moreover, the viscoelastic properties of cement raise serious doubts concerning the relevance of conventional l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199810000-00026
更新日期：1998-10-01 00:00:00
abstract：:Twenty-nine patients with tibial non-union or delayed union were treated by onlay grafting, using long struts from the ipsilateral fibula and without disturbing the non-union site. Internal fixation and excessive dissection can be avoided. Follow-up in 28 patients showed solid healing in all; 20/28 patients united the...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：:It has been reported that flexibility of the neck decreases after cervical laminoplasty. It also is known that kyphosis can be an unfavorable result after posterior decompression surgery of the cervical spine. To examine whether a decrease in cervical mobility resulting from contracture of the cervical spine helps pre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200208000-00016
更新日期：2002-08-01 00:00:00
abstract：:Primary total hip arthroplasties were performed in 108 patients (116 hips) using a porous coated anatomic (PCA) hip system. Nineteen (22 hips) of 108 patients (116 hips) who had a subsidence of a PCA femoral stem more than 3 mm were studied for the time onset, the amount of stem subsidence, and outcomes. A minimum fol...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-10-01 00:00:00
abstract：:Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Dual energy xray absorptiometry was investigated as a method for evaluation of the strength of closed tibial fractures. In 40 goats, a closed midshaft fracture was created in the left tibia. The fractures were stabilized with an external fixator. After 2 weeks (n = 21) and after 4 weeks (n = 19), both tibias were expl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200011000-00035
更新日期：2000-11-01 00:00:00
abstract：:Distraction osteogenesis is used to treat atrophic nonunion and focal osteomyelitis. It enhances blood vessel formation in the distracted callus and in the surrounding soft tissues. Long-term angiogenesis, however, is not well described. We hypothesized newly formed blood vessels persist in the surrounding muscles unt...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238795.82466.74
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Revision TKA is a serious adverse event with substantial consequences for the patient. As the demand for TKA rises, reducing the risk of revision TKA is becoming increasingly important. Predictive tools based on machine-learning algorithms could reform clinical practice. Few attempts have been made to combin...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001343
更新日期：2020-09-01 00:00:00
abstract：:In the past ten years, three related prostheses (Freeman-Swanson, ICLH, Freeman-Samuelson) have been used at the London Hospital. The new findings reported in this article are the result of cementless fixation of the ICLH prosthesis has not deteriorated with time; the patellofemoral complications and postoperative lim...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-04-01 00:00:00
abstract：:Bilateral simultaneous rupture of the quadriceps tendons is very rare and occurred in an 82-year-old man. This may be the fifth case to have been reported in the English literature. Only minor stress on extensor mechanisms preceded the ruptures. Interrupted mattress sutures restored muscle continuity and function. A "...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：:The treatment of the dislocated radial head in a late Monteggia lesion remains a matter of controversy. Annular ligament reconstruction using a strip of triceps tendon is a commonly used technique. Although most published series report good and excellent results, the overall complication rate of this procedure is not ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-09-01 00:00:00
abstract：BACKGROUND:Locking titanium plates revolutionized the treatment of osteoporotic and metaphyseal fractures of long bones. However as with any innovation, with time new complications are identified. One of the problems with titanium locking plates is removal of screws, often attributable to cold welding of screw heads in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1508-0
更新日期：2011-02-01 00:00:00
abstract：:This preliminary report outlines the rationale for a new approach to deep-vein thrombosis (DVT) prophylaxis in total knee arthroplasty (TKA) patients and describes preliminary hematologic and venographic findings. A protocol was employed to (1) document a series of hematologic events surrounding cemented TKA and the a...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1989-11-01 00:00:00
abstract：:Twenty-nine children were treated for bicycle spoke injury, which occurred while they were sitting behind their riding parents. Their feet were caught in between the bicycle spoke and the frame rod. Five of these children suffered supramalleolar fracture. These fractures had a similar radiographic pattern, namely a gr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：:High variability in the time required for patients to have substantial pain relief after Neer-type subacromial impingement tests might help explain conflicting data regarding their effectiveness in guiding treatment and predicting surgical outcomes. To focus on quantifying temporal variability associated with a modifi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31804a8581
更新日期：2007-07-01 00:00:00
abstract：:Shoulder arthrodesis, while providing a useful and predictable solution to many problems associated with glenohumeral degeneration, has been less than desirable for many patients due to the frequent need for postoperative spica cast or airplane splint immobilization. A new technique of external fixation of shoulder fu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：:Today's surgeon is required to demonstrate a variety of professional competencies in an increasingly complex environment. Recently, the time available to train this surgeon has started to erode due to external pressures on administrators and faculty. This growing crisis has led to questions about how to optimize learn...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000224028.93355.8c
更新日期：2006-08-01 00:00:00
abstract：BACKGROUND:Low-cost indigenous megaprostheses used in the developing world are prone to mechanical failure but the frequency and causes are not well established. QUESTIONS/PURPOSES:We retrospectively analyzed the causes of failure, particularly design, and suggest changes to reduce the breakage. We also report our exp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1409-2
更新日期：2010-11-01 00:00:00
abstract：UNLABELLED:To determine whether inferior vena cava (IVC) filter placement protects patients with musculoskeletal tumors from fatal pulmonary embolisms (PE), we retrospectively analyzed the records of 81 patients who underwent surgery for pelvic and lower extremity malignancies. All 81 patients received an IVC filter an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0607-7
更新日期：2009-01-01 00:00:00
abstract：:The Short Form 36, The Toronto Extremity Salvage Score, and the 1987 and 1993 Musculoskeletal Tumor Society Rating Scales were compared as measures of functional status for patients with lower extremity sarcoma. The study included 97 patients with lower extremity sarcoma and evaluated each measure on the following mea...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
