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Postoperative MRI findings 5 years after lumbar microdiscectomy.
- Source :
-
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2019 Feb; Vol. 29 (2), pp. 313-320. Date of Electronic Publication: 2018 Nov 08. - Publication Year :
- 2019
-
Abstract
- Background: Lumbar microdiscectomy is a common procedure with satisfactory results; however, postoperative events like progressive adjacent level degeneration and perineural fibrosis can contribute to long-term pain. The purpose of the study was to evaluate MRI changes 5 years after lumbar microdiscectomy and assess their association with clinical parameters.<br />Materials and Methods: A prospective study enrolling 61 patients who underwent microdiscectomy. Changes between preoperative and postoperative MRI findings were recorded, and these findings were tested for associations with demographic, clinical and perioperative parameters. The measured imaging parameters were degeneration of the operated and adjacent discs and endplates, morphology of the disc herniation, facet joints arthritis and the presence of postoperative perineural fibrosis.<br />Results: Statistically significant differences were found between preoperative and postoperative morphology of the operated disc, facet joints arthritis and degeneration of the operated and caudal adjacent disc. There were no differences between preoperative and postoperative disc degeneration of the superior adjacent disc and in degeneration of the operated and adjacent endplates. Postoperatively perineural fibrosis was common; however, thecal sac compression and nerve root impingement were reduced. Age at the time of surgery was the only parameter associated with postoperative changes.<br />Conclusion: Five years after microdiscectomy, several postoperative MRI changes including operated disc's morphology, facet joints arthritis and degeneration of the operated and caudal adjacent disc were shown. Taking into consideration that participants were on average middle-aged, these changes could be attributed not only to the impact of the surgery but also to the natural history of lumbar spine degeneration.
- Subjects :
- Adult
Age Factors
Epidural Space pathology
Female
Fibrosis
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Period
Preoperative Period
Prospective Studies
Zygapophyseal Joint diagnostic imaging
Intervertebral Disc Displacement diagnostic imaging
Intervertebral Disc Displacement surgery
Lumbar Vertebrae diagnostic imaging
Magnetic Resonance Imaging
Microsurgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1068
- Volume :
- 29
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
- Publication Type :
- Academic Journal
- Accession number :
- 30411244
- Full Text :
- https://doi.org/10.1007/s00590-018-2338-0