Abstract:
Diagnosis of disc degeneration and herniation largely depends on Magnetic Resonance Imaging (MRI)
and X-rays which fails to detect early disc degeneration. This study was conducted to compare the
degenerative changes seen in histological assessment with T2-weighted MRI findings. The study
recruited 104 patients with lumbar disc herniation undergoing lumbar discectomy. Excised lumbar disc
fragments were taken for histology and T2-weighted MRI was conducted prior to the surgery. Excised
disc fragments were subjected to routine histology procedure and van Gieson stain for collagen was
performed on each specimen. Disc degeneration was assessed by histological parameters and T2-
weighted MRI findings. The majority of subjects (94.2%) showed degenerative changes of the excised
portion of the lumbar discs in histological assessment of the disc. However, T2-weighted MRI findings
of degenerative changes of the discs were comparatively less (35.6%). According to the histological
assessment, higher percentage (61.5 %) of discs were moderately degenerated while 7.7 % had severely
degenerated discs. All patients who were confirmed for disc degeneration with T2-weighted MRI (n=37)
had confirmed degenerative changes in the histological assessment as well. Histological degenerative
alterations were observed in the majority of patients when compared to detectable degenerative
changes in T2-weighted MRI suggesting the importance of histological assessment of degeneration in
the excised intervertebral disc fragments. As early degenerative changes are not detected by the
standard T2weighted MRI technique, if neglected, can progress to severe stages resulting in more
discomfort and pain to the patients
