James Kogan, M'D', D'A'B'R'

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James Kogan, M.D., D.A.B.R.

• Imaging of the Spine

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Brief History of Degenerative Disk Disease

• Descriptions of treatment for low back pain (LBP)
  date to Hippocrates (460-370 BCE), who reported
  joint manipulation and use of traction. Onset of
  LBP often is associated with bipedal ambulation.

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Frequency

• United States
• Lifetime incidence of LBP is reported to be
  60-90 with annual incidence of 5. Each year,
  14.3 of new patient visits to primary care
  physicians are for LBP, and nearly 13 million
  physician visits are related to complaints of
  chronic LBP, according to the National Center for
  Health Statistics.

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Causes

• The cause of LDDD is unknown. Several theories
  cite traumatically induced acute annular tear as
  the inciting pathologic event.
• Other theories suggest that degeneration of the
  lumbar disk is a natural part of aging.
• The cause of LDDD is most likely multifactorial.

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Morbidity

• Reports indicate that 40-50 of patients are
  symptom-free within 1 week and up to 90 of
  symptoms resolve without medical attention in
  6-12 weeks.

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Radiology Armamentarium

• Plain x-rays
• CT (Myelography)
• MRI

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CT machine
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MRI
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Anatomy of the Lumbar Spine
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X-rays
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MRI of Herniated Disk
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CT of Disk Herniation
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Status post fusion and cage device placement
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