Ponomarenko S. Ultrasonographic diagnosis of degenerative changes of the intervertebral disc of the lumbar spine.

Aim: To show the effectiveness in diagnosing degenerative changes of inter-vertebral disc of the lumbar spine by the designing and introduction of complex sonographic criteria. Based on the study of representative group of patients with degenerative changes of the lumbar vertebrae, a scientific dilemma for radiology and orthopedics was solved to show the effectiveness of using ultrasonography to diagnose this pathology in patients a form of primary method of investigation. A methodology of investigating the patients was developed. The echographic features for early diagnosis of the degenerative changes of the intervertebral discs of the lumbar spine was systematized and the criteria for differential diagnosis was defined. Diagnostic effectiveness of using ultrasonography was also shown by comparing ultrasonographic and intra-operative data. Diagnosing lumbar vertebral inter-vertebral disc herniation, the sensitivity of this method was 89,2 %, specificity - 66,6 %, accuracy - 87,1 %, fibrotic changes of the epidural spaces sensitivity was 91,1 %, specificity - 85 %, accuracy - 87,1 %, and hypertrophy of the ligamentum flavum sensitivity was 92,8 %, specificity - 88,2 %, accuracy - 90,3 %. Ultrasonographic classification of degenerative changes of the intervertebral discs of the lumbar spine and lumbar spine stenosis was developed. The nature of changes in the blood circulation in the epidural veins during disc herniation was studied.