Summary
We studied 30 patients with an uncomplicated clinical course after surgery for lumbar disc herniation, using gadolinium (Gd)-DTPA-enhanced 0.35 T spin-echo MRI within 4–12 days of operation: the goal was to define the normal healing process following this type of surgery. At surgery we found disc protrusion (10%), herniation (57%), or sequestration (33%). Postoperative MRI demonstrated major protrusion in 4% and minor protrusion in 27%. There was strong epidural enhancement in 83% and moderate enhancement in 17%. The enhancing tissue had mass effect in 67% of cases. Delineation of intraspinal structures was excellent after administration of Gd-DTPA. Although Gd-DTPA-enhanced MRI of the postdiscectomy lumbar spine gives good visualization of the intraspinal space, the rather high incidence of abnormalities seen on MRI in asymptomatic patients clearly demonstrates that post-operative assessment still depends strongly upon clinical examination, and that neuroimaging, however sophisticated, has a complementary role in the process of medical decision making.
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References
Waddell G, Reilly S, Torsney B, Allan DB, Morris EW, Di Paola MP, Birchner M, Finlayson D (1988) Assessment of the outcome of low back surgery. J Bone Joint Surg [Br] 70: 723–727
Cervellini P, Curri D, Volpin L, Bernardi L, Pinna V, Benedetti A (1988) Computed tomography of epidural fibrosis after discectomy: a comparison between symptomatic and asymptomatic patients. Neurosurgery 23: 710–713
Roosen N, Botzenhard A, Lins E, Bock WJ (1987) Computed tomography (CT) findings during the first two weeks after uncomplicated surgery for lumbar disk herniation. In: Calabro A, Leonardi M (eds) Computer aided neuroradiology. CIC Edizioni Internazionali, Rome, pp 507–510
Sotiropoulos S, Chafetz NI, Lang P, Winkler M, Morris JM, Weinstein PR, Genant HK (1989) Differentiation between postoperative scar and recurrent disc herniation: prospective comparison of MR, CT, and contrast-enhanced CT. AJNR 10: 639–643
Burton CV, Kirkaldy-Willis WH, Yong-Hing K, Heitthoff KB (1981) Causes of failure of surgery on the lumbar spine. Clin Orthop 157: 191–199
Ros JS, Modic MT, Masaryk TJ, Hueftle MG (1988) The postoperative lumbar spine. Semin Roentgenol 13: 125–136
Hammer B, Boehm-Jurkovic H, Nedden D zur, Valencak E, Moshenipour I (1986) Der Wert der frühen postoperativen CT-Untersuchung nach lumbaler Bandscheibenoperation. ROEFO 145: 586
Steiner H (1989) MR-Tomographie nach lumbalen Bandscheibenoperationen: differentialdiagnostische Möglichkeiten durch Gd-DTPA. ROEFO 151: 179–185
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© 1991 Springer-Verlag
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Roosen, N. et al. (1991). Gadolinium-DTPA-enhanced MRI of the asymptomatic postdiscectomy lumbar spine: early postoperative results. In: du Boulay, G., Molyneux, A., Moseley, I. (eds) Proceedings of the XIV Symposium Neuroradiologicum. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-49329-4_33
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DOI: https://doi.org/10.1007/978-3-642-49329-4_33
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