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Clinical Application of the recommendations of the Combined Task Force on Lumbar Disc Pathology 2008

General Spine

Lawrence D Buadu, MD, Ph.D.,
Alexander Vogel, MD, Non ASSR Member
Jose Echeverri, MD, Non ASSR Member

Scientific Poster

Exhibit Panels: 1

Purpose

Objective: Lumbar degenerative disc disease is perhaps the most common pathologic entity encountered by the neuroradiologist, and is certainly among the most common entity encountered by the general radiologist. Low back pain is a significant problem in clinical medicine, affecting as many as 84% of adults over their lifetime, disabling approximately 11% for at least two weeks, accounting for approximately 2.5% of medical visits, and approximately US $100 billion in direct and indirect costs (1 - 3). The changes encompassed in this category are broad, and their relationships to low back pain are obscure. Inconsistent communication between diagnostic imagers and clinicians contributes unnecessarily to this obscurity. In recognition of this, in 2001 the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and the American Society of Neuroradiology proposed a uniform nomenclature to describe the variety of lumbar degenerative disc pathology (4). This framework has gained wide acceptance. We seek to illustrate the relationship between between the nomenclature these authors provide and the spectrum of disease seen in clinical practice in order to illuminate its application to clinical practice. Examples of each type of pathology and descriptor will be shown and correlated with key images to demonstrate the relevant pathology and the reasoning behind the classification of each lesion.

Learning Points:

1. Illustrate with representative examples, the application of the recommendations and descriptors of the Combined Task Force in the clinical setting.

2. Highlight and discuss some of the challenges that may arise in the application of these recommendations

References

1. Cassidy JD, et al. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998 Sep 1;23(17):1860-6; discussion 1867.
2. Hart LG, et al. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine 1995 Jan 1;20(1):11-9.
3. Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am. 2006 Apr;88 Suppl 2:21-4.
4. Fardon DF, et al. Nomenclature and Classification of Lumbar Disc Pathology. Recommendations of the Combined Task Forces of the North American Spine Society Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine 2001 Mar 1; 26(5): E93-E113.

Financial Disclosures: None