Medical Media Images

Sunday, June 22, 2014

What Surgery did Tiger Woods have? Microdiscectomy Shown and Explained

Tiger Woods has announced his return to competitive Golf for the Quicken Loans National this weekend after recuperating from a Microdiscectomy Back Surgery for the last three-and-a-half months. He had been struggling with Back Pain since last Summer, starting in the final round of the PGA Championships. After that, his painful episodes became more frequent. Following almost 9 months of escalating symptoms, he finally underwent Surgery by Neurosurgeon, Dr. Charles Rich on March 31st in Park City, Utah. The choice of Surgeon and location took many Spine Surgeons by surprise. Park City, Utah is primarily known as a Ski Resort, not a Mecca for Spine Surgery. Most experts would have expected the Surgery to take place at a well known Spine Institute by a very well known Spine Surgeon. It is almost certain that Tiger Woods had multiple consultations by a variety of Spine Surgeons to see if Surgery could be the answer. Is it possible that he was told "no" by at least some of the them? That could explain the unusual choice of Surgeon and location of the Surgery.



Is this the end of Tiger's back troubles? Not necessarily. As we saw today, he reinjured his back after jumping into a bunker at Bridgestone.

To further understand the answer, we have to first take a look at Disc Herniations in general and specifically Microdisctomy Surgery.

Microdiscectomy Surgery is performed for Disc Hernations of the Low Back. These Disc Herniations frequently put pressure on the Spinal Nerves located next to them. The Nerves becomes irritated and inflamed which often causes back spasms and pain, as well as numbness or even weakness in the legs (Sciatica). A Microdiscectomy is primarily performed for leg pain (Sciatica) related to the Disc Herniation. While back pain can be a byproduct of a Disc Herniation, most Spine Surgeons would not offer Surgery for patients whose main complaint is Low Back Pain. Why? Because the Surgery addresses specifically the pressure on the Spinal Nerve. Removing the pressure typically resolves the Nerve Pain to the leg, not specifically Low Back Pain. The Media Reports did not mention Leg Pain (Sciatica) as Tiger Woods's primary issue, but rather Back Pain. If that has been consistently the case, why did he have a Microdiscectomy?

Lets first take a look at the Anatomy of the Low Back  to help us understand Disc Herniations and Microdiscectomy Surgery. Here is a Color MRI of the Low Back (Lumbar Spine) which shows us the Anatomy of the Spine. Notice the location of the Spinal Disc and the Spinal Nerves. This Image is Interactive. Just move your Mouse Cursor over the Image and see the Image Tags come alive. Each tag displays text to explain a specific structure (If the tags do not load correctly due to slow Browser Speeds, just refresh the page).



Sagittal Color MRI Lumbar Spine Anaotmy Medical Image
Interactive Color MRI of the Anatomy of the Low Back (Lumbar Spine)

Here is another view of the Anatomy of the Low Back. This Image shows a perspective of a horizontal slide across the Low Back. Combining this view with the one above will give you a 3-Dimensional understanding of the Spine. This Image is also Interactive.


Axial Color MRI Lumbar Spine Anatomy Medical Images
Interactive Color MRI of the Anatomy of the Low Back


The next Image shows a Disc Herniation of the lowest Disc in the Low Back (L5/S1). Notice the red material which has migrated (herniated) from the center of the Disc backwards. This Image is also Interactive.


Sagittal Lumbar Spine Color MRI of a Disc Herniation
Interactive 3-D Color MRI showing a Disc Herniation


This Image shows you a Disc Herniation from the perspective of a horizontal slice across the Low Back. This is a very important perspective because now you can see how a Disc Herniation can push on a Spinal Nerve. The top Image on the right shows a Normal Disc and Spinal Nerve. The Image below it shows a Disc Herniation and a compressed Spinal Nerve. This Image is also Interactive.


Axial Color MRI Lumbar Spine Normal Disc and Disc Herniation
Interactive Color MRI of the Low Back showing a Normal Disc and a Disc Herniation
During the 9 months of suffering from the symptoms of a herniated Disc, Tiger Woods likely underwent numerous non-surgical treatments. These typically include Physical Therapy (PT), Medications, and Epidural Steroid Injections amongst others. Statistically only 5% of patients suffering from pain related to Disc Herniations undergo Surgery. However, that is only true for the general public, rather than elite athletes like Tiger Woods. Professional Golfers experience an enormous amount of force to their lower backs due to the force of the Spine's rotation which is inherent in a high powered Golf Swing. Once Professional Athletes sustain a Disc Herniation, especially one of Tiger Woods's caliber, it is far less likely that it will heal on its own. Add to that the fact that these athletes are under great pressure to return to full function to keep their endorsements and play schedules. So, trying to find a "surgical fix" is only natural and logical.

The question quickly becomes one of "what is the best Surgery"? There are a number of surgical options for Disc Herniations in the Low Back.
The least invasive types are Endoscopic Surgeries, done with the help of small fiberoptic tubes which are placed through tiny incisions (cuts). However in the practice of Spine Surgery, the success of the Surgery in large part depends on the Surgeon's ability to see and remove the entire Disc Herniation. Endoscopic Surgery often does not guarantee a full view of a Disc Herniation. This can jeopardize the success of the Surgery.
A Microdiscectomy is essentially one step up from an Endoscopic Surgery. It is more invasive because a larger incision (cut) is involved and more tissue has to be moved out of the way (dissection) in order to gain access to the Disc Herniation. In addition, at least some bone has be removed from the backbone (lamina) as well as from one of the motion joints (facet joints) of the Spine. While this is usually only a small part of the bone anatomy of the Spine, it can still have an impact on the stability, integrity and function of the Spine. This is certainly a concern for an athlete who functions at the highest level of their sport, like Tiger Woods. While the general surgical dogma states that removing less than 50% of the Facet Joint during a Microdiscectomy Surgery would not cause instability, it is generally unknown if this applies to top athletes as well. It is conceivable that removing even a fraction of the Facet Joint could change the function of this particular "motion segment" of the Spine, which could lead to ongoing Low Back Pain.
More aggressive and invasive Spine Surgeries, such as Spinal Fusions and Artificial Disc Replacements are not typically performed for patients who suffer from a first time Disc Herniation. These are more invasive options reserved for more significant Disc problems such as Degenerative Disc Disease, where the entire Disc looses function.

Let take a look at Color MRI Images which show how a Microdiscectomy is performed. A small Surgical Rectractor (blue) is placed from the back of the Spine to get access to the Herniated portion of the Disc. A Surgical Grasper is then used to remove the Disc Herniation. The Interactive Tags display text to explain the Surgery in more detail.



Sagittal Color MRI Lumbar Spine Microdiscectomy for Disc Herniation
Interactive Color MRI of  the Low Back showing a Microdiscectomy
Here is another view of the Surgery from the perspective of a horizontal slice across the Spine. Notice how part of the Facet Joint bone has to be removed to get access to the Herniated portion of the Disc (red), next to the Spinal Nerve (yellow).  This Image is also Interactive.



Axial Lumbar Spine Color MRI of a Microdiscectomy performed for a Disc Herniation
Interactive Color MRI of a Microdiscectomy

So, how successful are Microdiscectomy Surgeries? Overall they are quite successful in removing the herniated Disc material and relieving the compression of the Spinal Nerve. Usually this means pain relief of the leg pain (Sciatica) and return to function, which is often quoted as over 90%. However, the risk of re-herniating a Spinal Disc is a legitimate concern, especially for athletes involved in sports which create significant force and stress on the Disc. The reports of re-herniation amongst scientific publications vary widely. Most studies quote numbers in the 5-15% range. It is likely that these rates would be much higher in Professional Golfers.
What about Scar Tissue after a Microdiscectomy Surgery? Any Surgery causes scarring, of course. However, with Spine Surgery it is not the scarring on the Skin which is a cause for concern, but rather the scarring deep in the Spine, specifically around the Spine Nerve which was previously compressed by the Disc Herniation. In the process of the Surgery, this Spinal Nerve has to be touched and manipulated, which these Nerves are very sensitive to. Which of these Nerves develop scar tissue is thought to be related to numerous factors including how long a Nerve has been compressed, how much the Nerve is touched and manipulated during Surgery, how prone a patient is to developing scar tissue, etc. Scarring around the Nerve is a concern since it can lead to chronic Nerve Pain and also has the potential to jeopardize the Nerve's function.
Another variable in the outcome from Microdiscectomy Surgery is how long a Nerve has been compressed prior to Surgery. By reports, Tiger Woods waited approximately 9 months after he first had symptoms until the Microdiscectomy was performed. Is that too long? Not necessarily. Much depends on the degree of Nerve Compression and how much impairment of the Nerve's function existed during these 9 months. Nerve compression can manifest itself in a wide range of symptoms, ranging from mild numbness of part of the leg all the way to severe leg weakness and muscle atrophy. In the latter case, the function of the Nerve is severely impaired and the clock is ticking, meaning there is a limited amount of time before permanent Nerve damage occurs. Fortunately this is a very uncommon situation and not at all likely in Tiger Woods's case.

So, what happens if Tiger Woods develops a re-herniation of the injured Disc or develops instability of the Spine from the Surgery? If either of these events should require Surgery, things can get complicated for professional athletes at this level. With regard to re-herniations, the most common surgical options are to repeat the Discectomy, Lumbar Fusion Surgery and Artificial Disc Replacements. Repeating a Microdiscectomy or making a larger incision and performing an ordinary open Discectomy are logical options. However, the success rates decline and further scarring of the Spinal Nerves and potentially impairments of the stability of the Spine are real concerns.

What about a Spine Fusion or Artificial Disc Replacement. Neither of these may be very good options to maintain a career as a Professional Golfer competing at the highest level. A Spine Fusion would likely inhibit enough Spine motion and change the mechanics of the Spine to a point where his Golf Swing could change significantly.
An Artificial Disc Replacement would maintain some the Spine's natural motion, but it would likely not be the same quality or degree of motion. Artificial Disc Replacement devices were not designed for the types of forces the Spine experiences during a powerful Golf swing. The concern is not just damage to the Artificial Disc but also to the Anatomy around the Disc. Point in case is Retief Goosen, who suffered from Degenerative Disc Disease and had an Artificial Disc Replacement implanted in England in 2012. Subsequent to that he fractured a Facet Joint. It is possible that the Artificial Disc Replacement may have transferred too much force to the Facet Joints in the back of the Spine, which then caused the Facet Joint fracture. The bottom line is that these Devices may be good options for the general public, but are by and large untested in elite athletes.

Today, Tiger Woods had to withdraw at Bridgestone due to severe Spine Spasms. This is not a good sign and may indicate that the Microdiscectomy failed. He will likely undergo another MRI of his spine in the coming days to assess if he re-herniated the surgically repaired Spinal Disc.

We can only hope that Tiger Woods can play out his incredible career without any further Back trouble. His surgical options, if he needs another one, are very limited and not likely to maintain his career anywhere near the current level.


If you enjoyed this Blog, here are some recent blogs of related Spine topics:

1. What is Sciatica? Shown and Explained with Color X-Ray and Color MRI Images
2. What is an Epidural Injection? Shown and explained with Color MRI Images
3. What is a Spinal Fusion Surgery of the Low Back (Lumbar Spine)? Shown and explained with Color X-Ray Images
4. What are Artificial Disc Replacements of the Low Back? Shown and Explained with Color X-Ray Images
5. What is Degenerative Disc Disease (DDD) of the Low Back (Lumbar Spine)?
6. Disc Herniations of the Low Back (Lumbar Spine) shown and explained with Color MRI Images





Color X-Ray, Color MRI Images and Text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com. You can also find these and hundreds of other Images on the Navigation Bar at the top of the Blog.
Here is a Video about how Medical Media Images creates Color X-Ray, CT, and MRI Images:


 

The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

 


Friday, June 20, 2014

What is Degenerative Disc Disease (DDD) of the Low Back (Lumbar Spine)?

Degenerative Disc Disease also known as "DDD" is a very common Spine condition, most of us will experience in our lifetime. The Spinal Discs are our natural "shock-absorbers" between the Vertebrae. After so many cycles of absorbing and distributing the weight of our body, the Discs will eventually shows signs of wear and tear.

                             What is a Spinal Disc?

Before we go into more detail about DDD, lets first take a look at the Spinal Disc and the Anatomy around it, to help us understand why DDD happens. The Image below is a MRI Scan which has been converted into Color to help you see the Anatomy more clearly. The whole body MRI on the left is designed to show you where in the body the Image on the right is taken from.
This Image is Interactive. Just move your Mouse Cursor over the Image and see the Image Tags come alive. Each tag displays text to explain a specific structure. If the Image tags do not display correctly due to slow Browser Speeds, just refresh the page.


Sagittal Lumbar Spine Color MRI of the Spine Anatomy
Interactive Color MRI of the Anatomy of the Low Back (Lumbar Spine)

Now that we have seen the Anatomy of the Low Back, lets talk about DDD.


                  Why do we get Degenerative Disc Disease?

DDD is the result of wear and tear on the Spine due to the combination of our constant exposure to gravity, the Spine's motion, and weight bearing over time. Genetics and small injuries sustained over time can cause DDD at earlier ages then otherwise expected.

Who is at risk to develop DDD at an earlier age?
1. Smokers - due to diminished blood supply and Oxygen to the Disc
2. People with careers which involve long periods of driving (truck drivers, etc.) - due to the vibration
3. People with a Family History of DDD - genetics
4. Patients with Obesity - increased weight on the Disc
5. Patients with a history of significant Spine trauma

Simply put, our Discs are similar to water-filled balloons. At Birth, our Discs are made up of roughly 80% water. So, the proper function of this "shock-absorber" is in good part related to the water content. Starting in the 3rd decade of life, we begin to lose some of the water inside the Disc. At the same time, some of the important proteins in the core of our Disc (called the "Nucleus) diminish as well. These proteins are replaced by tougher fibers called "Collagen" which do not attract and maintain water inside the Disc. This causes the Disc to get firmer and less flexible over time, just like a shock-absorber which wears out in our car. The loss of elasticity also causes the Disc to lose some of its height. This is the main reason why we shrink with age.


                    Is Degenerative Disc Disease Painful?

Only a small percentage of patients who have DDD actually experience ongoing back pain. Most patients only experience mild or intermittent back pain. How is that possible? The answer is likely very complex and has much to do with our individual body chemistry, our ability to tolerate and perceive pain, our overall mental and physical health, etc.
Studies have shown that up to 1/3rd of people in their 40's will have some signs of DDD on an MRI, yet less than 10% of them experienced symptoms.


                          Does DDD cause Bone Spurs?

As the Disc gets firmer and smaller, the Vertebrae next to the Degenerated Disc have to absorb more pressure and force. This causes Bone Spurs to develop. Depending on the location and size of these Bone Spurs, Spinal Nerves can become compressed potentially causing pain, numbness and weakness in the legs. This is called "Spinal Stenosis".

Here is a Color X-Ray which shows the Bone Spurs from DDD. Notice the red tips coming off the Vertebrae. These are the Bone Spurs.

AP Color X-Ray showing Degenerative Disc Disease (DDD) and Bone Spurs

                  What kinds of Symptoms does DDD cause?

As mentioned above, most people who have signs of DDD on X-Rays or MRI Scans do not actually have significant symptoms such as back pain. However for patients who do suffer symptoms, here are some common ones:

1. Low Back Pain, typically in the small of the back, radiating to the sides of the Spine
2. Low Back Pain which is worse with activity
3. Low Back Pain with forward bending
3. Low Back Pain which is worse when having to be in the same position for longer periods of time
4. Stiffness in the low back, often worse in the morning, improved during the day with activity
5. Muscle spasms in the Low Back
6. Loss of mobility in the Low Back
7. Leg pain, numbness and weakness if the DDD causes pinched Spinal Nerves


                        Does DDD cause Joint Pain as well?

Each segment of the Spine is made up of one Spinal Disc in the front of the Spine and two Spine Joints (Facet Joints) on the back of the Spine.

Lets take a look at another Color MRI of the Low Back (Lumbar Spine) to see the relationship between the Spinal Disc and the Spinal Joints (Facet Joints). This Image is also Interactive.


Axial Lumbar Spine Color MRI showing Lumbar Spine Anatomy
Interactive Color MRI showing the Spine Anatomy as a Horizontal Slice across the Low Back
What you saw in the Image above shows that the Disc and Facet Joints form a Triangle. When the Disc-part of the Triangle degenerates, more weight and mobility is transferred to the other two sides of the Triangle, which causes more stress on the Facet Joints. Like most joints in the Body, the Facet Joints are prone to degeneration and Arthritis. In this situation, both the Discs and Facet Joints can become a source of back pain. This can make a precise location and source of the Back Pain difficult. Sometimes more than part of our Spine's Anatomy causes symptoms of Back Pain.

                               How is DDD diagnosed?

Doctors typically use a combination of the patient's history, physical examination and Radiology Images (X-Ray, CAT Scan, MRI) to make the diagnosis of DDD. While the Radiology Images can show DDD easily, it can be difficult for doctors to determine that what the Images show is the actual source of the patient's pain. The patient history and physical exam can help narrow things down.

Here is what DDD can look like on a Color converted X-Ray. The red arrow points to a degenerated Disc. This Image is also Interactive.



Lateral Lumbar Spine Color X-Ray showing Degenerative Disc Disease (DDD)
Interactive Color X-Ray of the Low Back showing DDD
Next we can take a look at a Color Converted MRI of the Low Back to see what DDD looks like on an MRI. Notice how the Degenerated Disc has lost most of its height. This Image is also Interactive.

Interactive Color MRI of the Low Back (Lumbar Spine) showing DDD
Here is a Color MRI which shows a Disc suffering from DDD (red arrows) of the Low Back (Lumbar Spine) from the front. You can see some of the Organs such as the Kidneys (green) next to the Spine.



                                   How is DDD treated?

Depending on the severity of the DDD and how it impacts on a patient's quality of life, non-surgical and surgical options exist.

I. Nonsurgical Options:

a. Weight Loss
    Overweight patients can get some benefit from weight loss by reducing the weight loaded on the 
    Spine. In combination with exercise which can benefit the Spine Muscles, weight loss can be a
    significant "self-help" form of treatment for DDD.

b. Tobacco Cessation
    Nicotine reduces blood flow and Oxygen to the Spine and Spine Muscles. Stopping the Nicotine in
    combination with exercise can be another "self-help" method for patients with DDD.

c. Alternative Medicine
    Chiropractic Care can help by restoring and maintaining the mobility of the Spine which is often  
    lost due to muscle spasms and pain related to DDD.
    Acupuncture and Massage Therapy can also help control the pain and spasticity of the muscles in
    DDD.
    Alternative Medicine can open a window of opportunity to help patients become more active.

d. Physical Therapy (PT) and Spine Exercises
    PT often offers specific interventions such as Ultrasound treatments, Spine Traction, Manual
   Therapy and Exercises to help patients with DDD. The goals of PT treatments are to maintain and
   restore the Spine's function, maintain muscle balance, Spine stability, and mobility.

e. Self Help Tools
    These devices range from back braces and supports to ergonomic chairs, mattresses, pillows and
    inversion tables amongst others. It is generally best to research each item and read reviews.

f. Medications
   Medications used to treat pain related to DDD often involve Non-Steroid Anti-Inflammatory Drugs
   (NSAIDS, e.g. Ibuprofen, Naproxen Sodium, etc.), Muscle Relaxants, Pain Killers (Narcotic
   Medications, e.g. Codeine, Hydrocodone, Oxycodone, etc.), Topical Medications (pain relieving
   creams, e.g. Capsaicin, etc.), low dose Antidepressants, etc.

g. Spine Injections
   Pain Specialists (Anesthesiologists, Physiatrists, etc.) often use steroid based injections to help with
   pain related to DDD. Their effectiveness is often based on the origin of the pain which can be
   multifactorial in DDD. Aside from the Degenerated Disc, the Spine Joints (Facet Joints), Spine 
   Muscles, Ligaments, and Spinal Nerves can become a source of pain.
   Here are some commonly performed Spine Injections:
   1. Epidural Steroid Injections
   2. Facet Joint Injections
   3. Muscle Blocks
   4. Discogram

Here is a Color MRI of an Epidural Injection. This Image is also Interactive.



Sagitall Color MRI Lumbar Spine Epidural Injection
Interactive Color MRI of a Lumbar Spine Epidural Injection

II. Surgical Options

Surgery is typically only considered as an option if all conservative, less invasive options have been exhausted and a patient's quality of life is significantly impaired.

The surgical options depend in large part on the:

1. Severity of the DDD
2. Number of Discs affected by DDD
3. The Surgeon's certainty that the patient's symptoms are in fact related to DDD
4. The patient's health
5. Which types of surgical options are covered by the patient' insurance
6. Types of Surgeries offered by the Surgeon

Here are two commonly offered Surgeries as a treatment for DDD:

A. Artificial Disc Replacements (ADR)
ADR's replace a Degenerated Disc with an Artificial one. ADR's are typically performed for Discs suffering from moderate to moderate-severe Degeneration. The most severe forms of DDD may involve too much Degeneration of other parts of the Spine Anatomy (Facet Joints, Spinal Nerves, etc.) to be an option for ADR Surgery. The fear is that replacing the Degenerated Disc would not eliminate some of the other potential sources of back pain.
ADR Surgery is most commonly performed through the Abdomen which is the easiest way for Surgeons to gain access to a large part of the Disc. The majority of the diseased Disc is removed prior to the implantation of the ADR.
Two ADRs are currently FDA approved in the U.S. (Prodisc-L, Charite), however numerous other ones are either in development in the U.S. or available overseas.
The goal of ADR Surgery is to maintain some of the mobility of the diseased Disc segment.

Here are some Images of ADRs implanted in the Low Back (Lumbar Spine). The bottom Disc has been surgically fused, while the two Discs above are replaced by ADRs. This Image is Interactive.



Lateral Lumbar Spine Color X-Ray of Artificial Disc Replacements
Interactive Color X-Ray of a 2-Level Artificial Disc Replacement
Here is a Color X-Ray which shows the mobility of an ADR. This Image is also Interactive.


Interactive Color X-Ray showing the mobility of an Artificial Disc Replacement
B. Lumbar Fusion Surgery:

Lumbar Fusion Surgery aims to remove the motion at a diseased Disc segment, since this motion is abnormal and thought to be painful. While Fusion Surgeries have been performed for over 100 years, the technology used for this Surgery has vastly expanded in the last decade. New, less traumatic approaches to the Spine, improved designs of the Spine Implants, and materials which can improve the chances for a complete bone fusion have given Surgeons more options and optimism.

Here are some Color X-Ray Images of Lumbar Fusion Surgery. The first Image is taken from the front. This Image is Interactive.



AP Color X-Ray Lumbar Spine Fusion Surgery
Interactive Color X-Ray of a Lumbar Fusion from a front view (AP)

Here is the side-view Image. This Image is also Interactive.


Lateral Color X-Ray of a Lumbar Fusion Surgery
Interactive Color X-Ray of a Lumbar Fusion from a side view
There are a number of less commonly utilized but emerging technologies which show promise as treatments for DDD. For early stages of DDD, Stem Cell Injections into the Disc are gaining ground.
Also, minimally invasive treatments such as "Interspinous Process Devices" are offering alternatives to the more conventional Fusion Surgeries. However, Surgeons must determine which technology and technique is in the best interest of patients to allow patients to make informed decisions on their care.

Here are some related Blog Topics from recent MMI Blogs:

1. What is Spinal Stenosis? Shown and explained with Color MRI Images
2. What is a Spinal Fusion Surgery of the Low Back (Lumbar Spine)? Shown and explained with
    Color X-Ray Images
3. What is a "Spondylolisthesis" of the Low Back (Lumbar Spine)? Shown and explained with Color
   X-Ray and Color MRI Images.
4. What are Artificial Disc Replacements of the Low Back? Shown and Explained with Color X-Ray Images 
5. Disc Herniations of the Low Back (Lumbar Spine) shown and explained with Color MRI Images
6. What is Sciatica? Shown and Explained with Color X-Ray and Color MRI Images
7. What is an Epidural Injection? Shown and explained with Color MRI Images
8. Lumbar Facet Joint Injection for Low Back Pain shown on a Color MRI
9. What is a Spinal Discogram Injection? Shown and Explained with Color MRI Images

Color X-Ray, Color MRI Images and Text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com. You can also find these and hundreds of other Images on the Navigation Bar at the top of the Blog.
If you would like to know more about how Medical Media Images creates Color X-Ray, CT, and MRI Images, here is a Video:


 

The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

 

Wednesday, June 18, 2014

Medical Images of Scoliosis shown on Color X-Rays

Scoliosis is a common condition of the Spine which is typically discovered in our adolescence. X-Rays are typically taken at certain intervals to assess the status of the Scoliosis. Typical Black and White Scoliosis X-Rays show the disease, but can be difficult for patients and family members to appreciate fully.

Medical Media Images, a Golden, Colorado based company has created a method to convert ordinary X-Ray, CT, and MRI Images into Color. These Images show the Anatomy of the Spine in ways never seen before.

Here are some examples which show Scoliosis. The first Image is a Color X-Ray of a typical Scoliosis which involves the Mid and Low Back (thoraco-lumbar). Notice how this Scoliosis turns to the left in the Mid Back (thoracic spine) and then comes back to the right in the Low Back (Lumbar Spine). This is called a "compensation", which allows a patient to be overall relatively straight. This Image is Interactive. As you move your mouse cursor over the Image, Interactive Image tags appear. Each Tag explains a specific part of the Image with text. If the Tags do not display correctly due to slow Browser Speeds, just refresh the page.


AP Scoliosis X-Ray showing a Thoraco-Lumbar Scoliosis
Interactive Color X-Ray of a Scoliosis

To measure the degree of a Scoliosis, doctors use something called a "Cobb Angle" measurement. This next Image shows the measurement, which is also used to assess the progression of a Scoliosis over time. The main part of this Scoliosis has a 30 degree Curvature.


AP Scoliosis Color X-Ray showing Cobb Angle Scoliosis Measurements
Color X-Ray of a Scoliosis with Cobb Angle Measurement

Here is the same Image shown as a 3-D Color X-Ray. This helps to bring out some of the hidden details of the Image. Medical Media Images produces the world's only 3-D Color X-Rays.


3-D Color X-Ray of a Thoraco-Lumbar Scoliosis
3-D Color X-Ray of a Scoliosis

The next Image is a Color X-Ray of a severe Scoliosis. This type of Scoliosis often requires Surgery since it can impair the function of the Heart and Lungs. The Cobb Angle Measurement shows a 90 degree Curvature.


AP Scoliosis X-Ray of a severe Scoliosis with Cobb Angle Measurement
Color X-Ray of a severe Scoliosis with a 90 degree Curvature

The Image below is a Color X-Ray of a Scoliosis and a Scoliosis Surgery. The Scoliosis Surgery uses Titanium Rods and Screws to straighten the Spine. This Image is Interactive. The Interactive Tags explain the Anatomy with text.

Interactive Color X-Rays of a Scoliosis and a Scoliosis Surgery


Color X-Ray, Color MRI Images and Text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com. You can also find these and hundreds of other Images on the Navigation Bar at the top of the Blog.
Here are some related Blogs from MMI which go into more detail about Scoliosis:

1. How can you tell if a Scoliosis is getting worse? Shown and explained with Color X-Ray Images
2. What is a Scoliosis? Shown and Explained with Color X-Ray Images

If you would like to find out more about Medical Media Images, here is a brief Video:
 

The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

Tuesday, June 17, 2014

Medical Images of the Knee Joint seen on Color MRI and Color X-Ray Images

The Human Knee Joint can now be seen in Color. Conventional X-Ray and MRI Images how the Knee in Black and White. This makes it difficult for viewers without formal training in Radiology to appreciate the Anatomy of the Knee Joint and specific Medical and Surgical conditions.

Medical Media Images has created the technology to convert ordinary Black and White X-Ray, CT, and MRI Images into Color. These Images offer an entirely new way to see the Human Anatomy in Color. Previously medical color illustrations came closest to showing the Human Anatomy in Color. However, they lacked in authenticity since they are not based on real patients. This has been solved by the color conversion of Radiology Images.

Here are some examples. The first Image is a Color X-Ray of the Knee. This Image has Interactive Image Tags. As you move your mouse cursor over the Image, the Interactive Tags appear. Each tag displays text to explain a specific part of the Anatomy. If the Tags do no not load properly due to slow Browser Speeds, just refresh the Image.



Lateral Color X-Ray of the Knee Joint showing Normal Anatomy
Interactive Color X-Ray of the Knee Joint


The next Image is a Color X-Ray of a Total Knee Replacement. Notice how a Knee Replacement consists of two metal components, one on the bottom of the Thigh Bone (Femur) and one at the top of the larger of the two lower Leg Bones, the Tibia. A plastic core separates the two metal components. This "cushion" is not visible on an X-Ray. This Image is also Interactive.



AP Color Knee Joint X-Ray showing a Knee Replacement (TKA)
Interactive Color X-Ray showing a Knee Replacement (TKA)

The Image below is a Color MRI Scan of the Knee Joint, which shows the Joint from a side-view slice (sagittal) perspective. Notice the Kneecap (patella) on the left. The Meniscus is shown in Blue.


Sagittal Color MRI of the Knee Joint showing the Meniscus and Patellar Ligament
Color MRI Image of the Knee Joint
 
The next Image shows a similar slice as the one above, however in this one the ACL (Anterior Cruciate Ligament) and PCL (Posterior Cruciate Ligament) can be seen. Both of these Ligaments help stabilize the Knee Joint, specifically when the Thigh Bone (Femur) moves forward or backward on the larger of the two lower Leg Bones (Tibia). This Image is also an Interactive Image with Tags.
 
Sagittal Color MRI Medical Image showing the ACL and PCL Ligaments of the Knee Joint
Interactive Color MRI of the Knee Joint showing the ACL and PCL Ligaments
 
We hope you enjoyed seen the Knee in Color on X-Ray and MRI Images!

You can find topics from our patient education Blogs at the bottom of the Page.



Color X-Ray, Color MRI Images and Text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com. You can also find these and hundreds of other Images on the Navigation Bar at the top of the Blog.

Here is a Video about Color X-Ray, CT, and MRI Images created by Medical Media Images:
 

The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

 

Monday, June 16, 2014

Medical Images of the Hip Joint seen on Color X-Ray and Color MRI Images

Radiology Images such as X-Rays, CAT Scans and MRI Scans can now be seen in Color. These color conversions offer a view of the Human Anatomy never seen before. Medical Media Images, a Golden, Colorado based company has created the technology to see Radiology Images in Color.

Ordinary Black and White X-Ray, CT, and MRI Images are difficult to visualize and understand for anyone without an advanced medical background. Color conversion of these Images creates highly visual, educational Images which allow the viewer to see and understand the information contained in these Images.

Here are some examples of the Human Hip Joint seen in Color. The first Image is a Color MRI Scan which shows the Hip Joints from the perspective of a Vertical Slice front view (coronal) through the Pelvis and upper part of the Legs. This Image is Interactive. Just move your mouse cursor over the Image and see the Image come alive with Interactive Image tags. Each tag displays information about a specific part of the Anatomy.

Interactive Color MRI of the Hip Joints. If the Interactive Tags do not load properly due to slow Browser Speeds, just refresh the Page.
Here is the same Image shown as a 3-D Color MRI:




The next Image is a view of a single Hip Joint on a Color MRI. Notice the Hip Joint is a "ball and socket" type of Joint. The "ball" is made up by the top of the Thigh Bone (Femur) which fits into the "socket" of the Hip Bone (Acetabulum of the Pelvis).


Coronal Color MRI of a Hip Joint
Color MRI of a Hip Joint

Now lets look at some Color X-Ray Medical Images of the Hip Joint. The Image below shows a degenerated Hip Joint. The Arthritis is shown in red. Notice how narrow the degenerated Hip Joint has become compared to the normal one on the opposite side. This Image is also Interactive.


AP Pelvis Color X-Ray showing Hip Joint Arthritis
Interactive Color X-Ray of Arthritis of the Hip Joint

The last Color X-Ray Medical Image shows a Hip Replacement which has been performed as a treatment for severe Arthritis of the Hip Joint. This device consists of two parts: A long stem which is placed into the Femur (thigh bone) which has a ball at the top; A cup which fits into the Hip Tone (acetabulum of the Pelvis)


AP Pelvis Color X-Ray of a Hip Replacement Total Hip Arthroplasty
Color X-Ray of a Hip Joint Replacement
 We hope you enjoyed the Images. Color X-Ray, Color MRI Medical Images and Text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com. You can also find these and hundreds of other Images on the Navigation Bar at the top of the Blog.

If you would like to find out more about Medical Media Images, here is a Video:
 
 

The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

 

Thursday, June 12, 2014

Medical Images of the Human Spine on Color X-Rays, CAT Scans, and MRI Scans

The Human Spine can now be seen in Color. Medical Media Images, a Colorado based company has developed the technology to convert X-Ray, CT, and MRI Images into Color. The results are amazing Images of the Human Anatomy in ways we have never seen before.

Patients and the general Public often have a difficult time seeing and understanding ordinary Black and White Radiology Images, even with the best explanations. However, seeing the Human Anatomy in Color allows the viewer to see and discern details of individual structures, diseases and surgeries.

The Human Spine is a common source of Radiology Images. After all, back pain is the second most common complaint which brings patients to the doctor (headaches are first). Lets take a look at the Anatomy of the Spine on Color Radiology Images.

This Image is an Interactive Color X-Ray of a Scoliosis. Move your mouse cursor over the Image to see the Interactive Image Tags. Each Tag displays text to explain a specific part of the Anatomy. Medical Media Images has combined Color Images with Interactive Technology to allow the viewer to interact with and learn from an Image.



Color Scoliosis X-Ray Thoracolumbar Scoliosis
Interactive X-Ray. If the Interactive Tags do not display correctly due to Slow Browser Speed, just reload the Page

Here is another Color X-Ray of a Spine Fracture. These fractures are called Compression Fractures. They are common in patients with Bone Thinning (Osteoporosis). This type of Image is called a "Reference Image", since a whole body Color X-Ray on the left provides a "reference" to the whole body. A viewer can see right away where in the Body the main Image is taken from.



Lateral Color X-Ray of a Lumbar Compression Fracture
Color X-Ray of a Compression Fracture of the Spine


The next Image is a Color CAT Scan. This Image shows degeneration of the Sacroiliac Joints from the perspective of a horizontal slice taken across the low back (axial).  This Image is also Interactive.
 
 
Axial Color CT Scan of Sacroiliac Joint Degeneration
Interactive Color CT Scan of a degenerated Sacroiliac Joints

Now lets move to MRI's, which show the most detail of the Human Body. This is a 3-D enhanced Color MRI which helps the viewer see more detail. Notice the Disc Herniation shown in red. This type of Image can help a viewer understand Disc Herniations with one look at an Image. Reading text about Disc Herniation can make it difficult to visualize this common Spine Condition. However, when combined with this Image, a viewer can gain visual and text perspectives.


3-D Color MRI Lumbar Spine Disc Herniation
Color MRI of the Low Back showing a Disc Herniation in red.
 
 
Here is one more Interactive Color MRI. This one shows the Low Back (Lumbar Spine) from a horizontal slice across the Spine (axial). This Image is also Interactive.


Axial Lumbar Spine MRI of the Lumbar Spine Anatomy
Interactive Color MRI of the Anatomy of the Low Back in cross-section

You can find hundreds of Color X-Ray, CT, and MRI Images on the Navigation Bar a top of the Page.

Don't miss our Patient Education Blog series at the bottom of the Page!


Here is a Video of how MMI creates Color Radiology Images:





The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.

 

What is a "Facet Joint"? Shown and Explained with Color X-Ray and Color MRI Images

The Facet Joints of the Spine are small Motion Joints located on the back of the Spine. Their job is to guide and limit the motion of the Spine. Our Spine consists of many "motion segments" which give us our overall mobility. Each "motions segment" consists of a Spinal Disc in the front of the Spine and two Facet Joints on the back of the Spine. Without the Facet Joints, the Spine would move in all directions equally well. However that would be too much motion which would put our Nerve Supply at risk. The Spinal Cord and Spinal Nerves are located within a large tube (Spinal Canal) at the center of the Spine. If Vertebrae could move too much, the Spinal Cord and Nerves would be stretched and twisted which they cannot tolerate. So, this is where the Facet Joints come in. They control the motion of the Spine, only allowing a certain degree which is safe for the rest of the Spine's Anatomy.

Lets take a look at a Color X-Ray which shows the Facet Joints of the Low Back (Lumbar Spine). The black arrows point to some of the Facet Joints. Not all Joints can be seen on a straight-on (AP) X-Ray of the Low Back. This Image is Interactive. As you move your mouse cursor over the Image, the Interactive Tags appear. Each Tag displays text to explain a specific part of the Anatomy.


AP Color X-Ray of the Lumbar Spine Facet Joints
Interactive Image. If the tags do not display correctly due to slow Browser Speed, just reload the Image.

The next Image is of the Facet Joints is from a slightly different position. This Color X-Ray is taken from an angle (about 45 degrees). With this type of X-Ray view (Oblique), the Facet Joints open wider, since their orientation is angled. The green arrows point at the Facet Joints of the Low Back.

Oblique Lumbar Spine Color X-Ray of the Lumbar Facet Joints


To get a better 3-Dimensional idea about the Facet Joints, lets take a look at a Color MRI of the Low Back (Lumbar Spine). This perspective is a horizontal slice across the Low Back. The Orientation Box on the whole-body Color MRI on the left, shows you where the slice is taken from. Notice how close the Spinal Disc and Facet Joints are to each other. The Spinal Nerves (yellow) travel right between them. So, if either a Spinal Disc becomes larger (herniates) or a Facet Joint develops Bone Spurs, the Spinal Nerves can become trapped. This is called "Sciatica" (spinal nerve pain in the leg).This Image is also Interactive.


Axial Lumbar Spine Color MRI Lumbar Spine Anatomy
Interactive Image. If the tags do not display due to slow Browser Speed, just reload the Image
Now lets take a look at Facet Joints which have degenerated. This next Interactive Color MRI shows you how different degenerated (arthritic) Facet Joints look from Normal ones. The red arrows point at the bone spurs which have developed as part of the degeneration. The Joint itself has become narrow as the Cartilage has worn off. This is also an Interactive Image.

Axial Color MRI of Lumbar Spine Facet Joint Arthritis Degeneration

Facet Joints in the low back are a common cause of Back Pain. Pioneers in Medicine first discovered the Facet Joints as the primary source of Back Pain and Sciatica. However, eventually, the Spinal Disc received more attention. In recent years, the Facet Joints have been given a higher priority as culprits of low Back Pain. This has lead to new interventions, including new types of Surgeries.

In our next Blog, we will discuss the Treatments for low Back Pain from Facet Arthritis. Stay tuned!
Check out our other Blogs at the bottom of the Page to see related Subjects!

Color X-Ray, Color MRI Images and Text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com. You can also find these and hundreds of other Images on the Navigation Bar at the top of the Blog.

If you want to learn more about how Medical Media Images creates Color X-Ray, CT, and MRI Scans, here is a Video:
 

The Content of this Blog Including text and images are Copyright Medical Media Images

General Disclaimer

Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.