Multiplanar Display Computerized Body Tomography Applications in the Lumbar Spine

This paper is the first report of an extensive clinical use of computerized body tomography (CBT) for diagnosis of spinal disorders. Meticulous care in gathering and analyzing CBT images is emphasized. The multiplanar display (MPD) technique illustrates an important software capability for spine cases. Clinical examples are presented in support of confident CBT diagnosis of lumbar disc abnormalities in addition to various forms of stenosis, and an outline for proposed indications for CBT in the spinal canal and spinal cord. Surgical and myelographic correlations indicate a significant future role for CBT in all categories of spinal disorders, particularly its sensitivity in demonstrating lumbar disc abnormalities. Spine work in this hospital has shown a sustained growth over the last two years and now represents the largest single CBT patient category (35-40% of CBT work during the 20 months preceding July 1, 1979). The results documented in this paper strongly contradict the minor status accorded CBT spine work in a recent two-part summary article in the New England Journal of Medicine. The authors think that spine work, paradoxically, represents a little recognized but potentially the strongest justification for continued development and deployment of body scanning equipment. Several research activities related to diagnosis of spinal disorders are discussed. These include high-resolution zoom scan modifications, dose reduction techniques, better reconstructed coronal and sagittal displays, a generalized oblique plane capability, and several forms of three-dimensional display.