Imagerie du disque intervertébral

RésuméL’utilisation très large de l’imagerie par résonance magnétique (IRM) permet une analyse morphologique précise du disque intervertébral (DIV) et de l’unité disco-vertébrale. L’IRM est une technique sensible, qui peut montrer des signes précoces de discopathie. L’utilisation d’une nomenclature standardisée de la discopathie dégénérative est nécessaire pour optimiser la prise en charge clinique des patients. Plusieurs classifications des lésions discales sont publiées. La classification de Modic est la plus utile et pertinente en pratique clinique.

With the wide use of MR imaging, it is now possible to examine the anatomy of the lumbar spine non-invasively, with excellent spatial and contrast resolution, in a short time. This has led to a better understanding of the frequency and spectrum of findings that can be present as part of the normal aging process without causing clinical symptoms. The nomenclature to describe disk lesions has been greatly influenced by two factors: the concept of disk degeneration throughout life and the understanding of the physiopathology of clinically relevant disk disorders. Ideally, the nomenclature used for imaging should correspond to clinical entities and help orient the referring physician as to treatment. Modic type 1 changes are likely to be inflammatory in origin and seem to be strongly associated with active low back symptoms and segmental instability of the lumbar spine.