Die Computertomographie beim lumbalen Kompressionssyndrom

Computertomography has been shown to be a reliable method for evaluation of lumbar compression syndromes. Excellent apparative equipment and differentiated examination techniques are required. As compared with myelography CT offers the advantages of a non-invasive procedure. Due to simultaneous axial visualisation of bone and soft tissue all components contributing to lumbar compression syndromes are included. This so far cannot be achieved by conventional radiographic methods. CT is superior to myelography concerning specificity and sensitivity of the diagnosis of primary and surgically treated herniated discs. It demonstrates extreme lateral dislocation of disc tissue as well as centrally located disc material at the L5/S1 level. Furthermore, compressing structures such like monosegmental osseous stenosis and stenosis of the spinal canal are well to be recognized. Tumors may be ruled out. Verification of postoperative hematoma and scar formation is of high clinical value. Myelography, however, remains being the method of choice when clinical symptoms are not to be appointed to a certain segment.