Skip to main content
SpringerLink
Log in

Principles of Postoperative Spine MRI

  • Chapter
  • First Online:
Book cover MRI of the Spine

Abstract

This chapter summarizes the basic principles of postoperative spine MRI. These include technical considerations and imaging protocols, interpretation of the postoperative spine, indications for intravenous contrast, and descriptions of acute and delayed complications. After reading this chapter, the reader should gain a basic understanding of how MRI in conjunction with a patient’s clinical presentation can be used as a troubleshooting tool to identify potential causes of postoperative symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Martin BI, Mirza SK, Spina N, Spiker WR, Lawrence B, Brodke DS. Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015. Spine. 2019;44:369–76.

    Article  Google Scholar 

  2. Weiss AJ, Elixhauser A. Trends in operating room procedures in U.S. Hospitals, 2001—2011. In: Trends in operating room procedures in U.S. Hospitals, 2001–2011 – statistical brief #171. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb171-Operating-Room-Procedure-Trends.jsp. Accessed 15 May 2019.

  3. Li G, Patil CG, Lad SP, Ho C, Tian W, Boakye M. Effects of age and comorbidities on complication rates and adverse outcomes after lumbar laminectomy in elderly patients. Spine. 2008;33:1250–5.

    Article  Google Scholar 

  4. Kalanithi PS, Patil CG, Boakye M. National complication rates and disposition after posterior lumbar fusion for acquired Spondylolisthesis. Spine. 2009;34:1963–9.

    Article  Google Scholar 

  5. Malhotra A, Kalra VB, Wu X, Grant R, Bronen RA, Abbed KM. Imaging of lumbar spinal surgery complications. Insights Imaging. 2015;6(6):579–90. https://doi.org/10.1007/s13244-015-0435-8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Phalke VV, Gujar S, Quint DJ. Comparison of 3.0 T versus 1.5 T MR: imaging of the spine. Neuroimaging Clin N Am. 2006;16:241–8.

    Article  Google Scholar 

  7. Hargreaves BA, Worters PW, Pauly KB, Pauly JM, Koch KM, Gold GE. Metal-induced artifacts in MRI. Am J Roentgenol. 2011;197:547–55.

    Article  Google Scholar 

  8. Hancock CR, Quencer R, Falcone S. Challenges and pitfalls in postoperative spine imaging. Appl Radiol. 2008;37:23–34.

    Google Scholar 

  9. Choi S-J, Koch KM, Hargreaves BA, Stevens KJ, Gold GE. Metal artifact reduction with MAVRIC SL at 3-T MRI in patients with hip arthroplasty. Am J Roentgenol. 2015;204:140–7.

    Article  Google Scholar 

  10. Del Grande F, Santini F, Herzka DA, Aro MR, Dean CW, Gold GE, et al. Fat-suppression techniques for 3-T MR imaging of the musculoskeletal system. Radiographics. 2014;34(1):217–33.

    Article  Google Scholar 

  11. Talbot BS, Weinberg EP. MR imaging with metal-suppression sequences for evaluation of total joint arthroplasty. Radiographics. 2016;36:209–25.

    Article  Google Scholar 

  12. Hayashi D, Roemer FW, Mian A, Gharaibeh M, Müller B, Guermazi A. Imaging features of postoperative complications after spinal surgery and instrumentation. Am J Roentgenol. 2012;199(1):W123. https://doi.org/10.2214/ajr.11.6497.

    Article  Google Scholar 

  13. Ross JS, Masaryk TJ, Schrader M, Gentili A, Bohlman H, Modic MT. MR imaging of the postoperative lumbar spine: assessment with gadopentetate dimeglumine. Am J Roentgenol. 1990;155:867–72.

    Article  CAS  Google Scholar 

  14. Sen K, Singh A. Magnetic resonance imaging in failed Back surgery syndrome. Med J Armed Forces India. 1999;55:133–8.

    Article  CAS  Google Scholar 

  15. Lee Y, Choi E, Song C. Symptomatic nerve root changes on contrast-enhanced MR imaging after surgery for lumbar disk herniation. Am J Neuroradiol. 2009;30:1062–7.

    Article  CAS  Google Scholar 

  16. Hyun SJ, Kim YB, Kim YS, Park SW, Nam TK, Hong HJ, Kwon JT. Postoperative changes in Paraspinal muscle volume: comparison between paramedian interfascial and midline approaches for lumbar fusion. J Korean Med Sci. 2007;22:646.

    Article  Google Scholar 

  17. Davies A, Hall A, Strouhal P, Evans N, Grimer R. The MR imaging appearances and natural history of seromas following excision of soft tissue tumours. Eur Radiol. 2004;14:1196. https://doi.org/10.1007/s00330-004-2255-y.

    Article  CAS  PubMed  Google Scholar 

  18. Acharya J, Gibbs WN. Imaging spinal infection. Radiol Infect Dis. 2016;3:84–91.

    Article  Google Scholar 

  19. Moritani T, Kim J, Capizzano AA, Kirby P, Kademian J, Sato Y. Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections. Br J Radiol. 2014;87:20140011.

    Article  CAS  Google Scholar 

  20. Radcliff K, Morrison WB, Kepler C, Moore J, Sidhu GS, Gendelberg D, Miller L, Sonagli MA, Vaccaro AR. Distinguishing pseudomeningocele, epidural hematoma, and postoperative infection on postoperative MRI. Clin Spine Surg. 2016;29:E471. https://doi.org/10.1097/bsd.0b013e31828f9203.

    Article  PubMed  Google Scholar 

  21. Sokolowski MJ, Garvey TA, Perl J, Sokolowski MS, Cho W, Mehbod AA, Dykes DC, Transfeldt EE. Prospective study of postoperative lumbar epidural hematoma. Spine. 2008;33:108–13.

    Article  Google Scholar 

  22. Pierce JL, Donahue JH, Nacey NC, Quirk CR, Perry MT, Faulconer N, Falkowski GA, Maldonado MD, Shaeffer CA, Shen FH. Spinal hematomas: what a radiologist needs to know. Radiographics. 2018;38:1516–35.

    Article  Google Scholar 

  23. Krishnan P, Banerjee TK. Classical imaging findings in spinal subdural hematoma – “Mercedes-Benz” and “cap” signs. Br J Neurosurg. 2015;30:99–100.

    Article  Google Scholar 

  24. Geannette CS, Salomon N. “Pearls and Pitfalls of the Postoperative Lumbar Spine: Anatomy, Lumbar Fusion Techniques, and Postoperative Complications.” American Roentgen Ray Society, 2019.

    Google Scholar 

  25. Lonstein JE, Denis F, Perra JH, Pinto MR, Smith MD, Winter RB. Complications associated with pedicle screws∗. J Bone Joint Surg. 1999;81:1519–28.

    Article  CAS  Google Scholar 

  26. Chun DS, Baker KC, Hsu WK. Lumbar pseudarthrosis: a review of current diagnosis and treatment. Neurosurg Focus. 2015;39:E10. https://doi.org/10.3171/2015.7.focus15292.

    Article  PubMed  Google Scholar 

  27. Kornblum MB, Fischgrund JS, Herkowitz HN, Abraham DA, Berkower DL, Ditkoff JS. Degenerative lumbar spondylolisthesis with spinal stenosis. Spine. 2004;29:726–33.

    Article  Google Scholar 

  28. Rahme R, Moussa R. The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. Am J Neuroradiol. 2008;29:838–42.

    Article  CAS  Google Scholar 

  29. Lang P, Chafetz N, Genant HK, Morris JM. Lumbar spinal fusion assessment of functional stability with magnetic resonance imaging. Spine. 1990;15:581–8.

    Article  CAS  Google Scholar 

  30. Domenicucci M, Ramieri A, Passacantilli E, Russo N, Trasimeni G, Delfini R. Spinal arachnoiditis ossificans: report of three cases. Neurosurgery. 2004;55:E1011. https://doi.org/10.1227/01.neu.0000137281.65551.54.

    Article  Google Scholar 

  31. Dimar JR, Glassman SD, Burkus JK, Pryor PW, Hardacker JW, Carreon LY. Clinical and radiographic analysis of an optimized rhBMP-2 formulation as an autograft replacement in Posterolateral lumbar spine arthrodesis. J Bone Joint Surg Am. 2009;91:1377–86.

    Article  Google Scholar 

  32. Mckie J, Qureshi S, Iatridis J, Egorova N, Cho S, Hecht A. Trends in bone morphogenetic protein usage since the U.S. Food and Drug Administration advisory in 2008: what happens to physician practices when the food and drug administration issues an advisory? Global Spine J. 2013;4:071–6.

    Article  Google Scholar 

  33. Lebl DR. Bone morphogenetic protein in complex cervical spine surgery: a safe biologic adjunct? World J Orthop. 2013;4:53.

    Article  Google Scholar 

  34. Sethi A, Craig J, Bartol S, Chen W, Jacobson M, Coe C, Vaidya R. Radiographic and CT evaluation of recombinant human bone morphogenetic protein-2–assisted spinal interbody fusion. Am J Roentgenol. 2011;197:W128. https://doi.org/10.2214/ajr.10.5484.

    Article  Google Scholar 

  35. Shah RK, Moncayo VM, Smitson RD, Pierre-Jerome C, Terk MR. Recombinant human bone morphogenetic protein 2-induced heterotopic ossification of the retroperitoneum, psoas muscle, pelvis and abdominal wall following lumbar spinal fusion. Skelet Radiol. 2010;39:501–4.

    Article  Google Scholar 

  36. Nguyen N-LM, Kong CY, Hart RA. Proximal junctional kyphosis and failure—diagnosis, prevention, and treatment. Curr Rev Musculoskelet Med. 2016;9:299–308.

    Article  Google Scholar 

  37. Argentieri EC, Koff MF, Breighner RE, Endo Y, Shah PH, Sneag DB. Diagnostic accuracy of zero-echo time MRI for the evaluation of cervical neural foraminal stenosis. Spine. 2018;43:928–33.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Weill Medical College of Cornell University, New York, NY, USA

    Karthik Krishnan & Darryl B. Sneag

  2. Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA

    Karthik Krishnan, Sophie C. Queler & Darryl B. Sneag

Authors
  1. Karthik Krishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sophie C. Queler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Darryl B. Sneag
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Darryl B. Sneag .

Editor information

Editors and Affiliations

  1. Division of Musculoskeletal Radiology, Thomas Jefferson University, Philadelphia, PA, USA

    William B. Morrison

  2. Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA

    John A. Carrino

  3. Division of Neuroradiology, Thomas Jefferson University, Philadelphia, PA, USA

    Adam E. Flanders

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Krishnan, K., Queler, S.C., Sneag, D.B. (2020). Principles of Postoperative Spine MRI. In: Morrison, W., Carrino, J., Flanders, A. (eds) MRI of the Spine. Springer, Cham. https://doi.org/10.1007/978-3-030-43627-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-43627-8_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43626-1

  • Online ISBN: 978-3-030-43627-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation