Lumbago or low back pain and radiologist

Jalal Jalal Shokouhi Radiologist: ISR,Tehran, IranM.H.Herischi Orthopedic surgeon: Baku,Republic AzarbayjanA.Norousi Neurosureon,Leopold clinic: Munich, GermanyH.Mirbagheri Ankle orthopedic surgeon: London U.K.Shahyar Pashae Anatomist: Tehran University, Iran

80% of population experience L.B.P at some point of their life

Prevalence in USA is 18% annual incidence is 15-29%

Male=Female

Self-limiting with 50% in 2 weeks, 90% by 6 weeks, 1% chronically disabled

Costs are 20 billion US Dollar to 50 billion annually.

10% of patients use 85-90% of the costs

Lumbar strenght: • 20% Bony spine, disc and lig.• 80% Muscles

Ethiology1. Disc herniation2. V-body disease3. Functional spinal unit disease “F.S.U” or motion segment (Two V-bodies and disc between) Three-Joint Complex = Disc + Facet Joints +(Vessels,Nerves,Muscle and Ligaments)4.Facet disease5.Spina bifida6.Malalignment7.Spondylolysthesis8.Spondylitis9.Spondylodiscitis10.TB, Brucellosis11.Pelvic infection12.Ankylosing spondylitis13.Aortic aneurysm14.Pancreas adenocarcinoma15.Rectal carcinoma16.Peptic ulcer17.Spondylosis18.Lumbar canal stenosis19.Primary bone tumor20.Myelomatosis21.Metastasis22.Osteoporosis23.Osteomalatia24.Retroverted uterus25.Prostate disease, BPH26.Urologic and Genital problems.27.Ankle problems

RadiologistAs a radiologist, in diagnosisAs an interventional radiologist, in treatmentAs a patient in general population, ”hard

working, bad sitting and no sporting”

Disk herniation17% under 40 years old22 % between 40 to 59 years old36 % those older than 60 years old

Imaging studies1.Rest2.Radiography”if symptoms do not resolve by

rest, specially age above 50”3.MRI4.MRI with GD in operated or tumoral cases.5.CT with and without contrast6.Myelography or CT-myelography7.Diskography

TREATMENT1.Rest2.Physiotherapy3.Neurosurgical and orthopedic “Medical-

Surgical”4.Interventional, less invasive5.Non-invasive “Facet therapy, periradicular

therapy, Neucleotomy”6.Back school