Journal of spinal disorders
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A case of a large L3-L4 intervertebral disc herniation causing a widening of the intervertebral foramen is reported. There was a soft-tissue mas within the spinal canal and intervertebral foramen. ⋯ There exists a degree of overlap between the imaging of herniated discs and spinal neurinomas. When this overlap involves several aspects, such as anatomic configuration, mass enhancement, and secondary foraminal dilatation, the differential diagnosis between a herniated disc and a neurinoma may be problematic.
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Inter- and intraobserver variability in grading lumbar fusion status radiographically was assessed. The objective was to determine the interobserver variability and intraobserver reproducibility in the assessment of two level noninstrumented lumbar fusions. Fifty sets of radiographs with anteroposterior, left and right bending, and flexion-extension lateral views were assessed by six observers of varying experience and background, with fusion status graded. ⋯ Intraobserver reproducibility was higher in more experienced observers. The results indicate only fair reliability in terms of interobserver agreement to grading of lumbar fusion status. Variability in assessing lumbar fusion radiographically may explain some of the variability in fusion rates reported in the literature and poor correlation that can be seen between clinical outcome and radiologic outcome.