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The clinical value of early postoperative MRI after lumbar spine surgery.
- Source :
-
British journal of neurosurgery [Br J Neurosurg] 2010 Feb; Vol. 24 (1), pp. 46-50. - Publication Year :
- 2010
-
Abstract
- Introduction: MRI scanning has historically been considered difficult to interpret in the early period following lumbar spine surgery, and hence of limited value. We investigate the hypothesis that MRI scanning within 6 weeks of lumbar spine surgery cannot accurately diagnose neural compression in symptomatic patients, and define the utility of postoperative MRI in this context.<br />Methods: A series of 32 consecutive patients had early postoperative MRI following lumbar discectomy or laminectomy for continued, worsening or new symptoms of neural compression. The neuroradiologists' reports were evaluated for the reported presence of neural compression and confidence level (low, medium, high). These MRI findings were then compared to the patients' subsequent course and findings of any surgery performed.<br />Results: Twenty of 29 scans (69%) were confidently predictive of the correct treatment pathway (reoperation with positive finding or conservative treatment with a good outcome) whereas 3/3 (100%) patients who had conservative management despite the MRI confidently suggesting compression had poor outcome. The MRI is highly likely to influence management: 11/14 (79%) patients with scans suggesting neural compression had revision surgery and 18/18 (100%) patients with no neural compression on MRI were managed conservatively.<br />Conclusions: Our data suggest that early MRI scanning after lumbar laminectomy or discectomy accurately detects neural compression at the surgery site in patients with continued or worsening symptoms.
- Subjects :
- Adult
Aged
Humans
Middle Aged
Nerve Compression Syndromes surgery
Postoperative Care
Postoperative Complications surgery
Reoperation
Time Factors
Treatment Outcome
Decompression, Surgical
Diskectomy
Lumbar Vertebrae surgery
Magnetic Resonance Imaging methods
Nerve Compression Syndromes diagnosis
Postoperative Complications diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1360-046X
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- British journal of neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 20158352
- Full Text :
- https://doi.org/10.3109/02688690903374067