The lumbar spine: postoperative magnetic resonance imaging

Area of Science:

• Radiology
• Neurosurgery
• Orthopedics

Background:

• Persistent low back pain following spinal surgery, known as failed back surgery syndrome (FBSS), presents significant diagnostic and therapeutic challenges.
• Conventional imaging may not adequately identify the diverse causes of FBSS.
• Magnetic Resonance Imaging (MRI) offers superior visualization of the postoperative lumbar spine.

Purpose of the Study:

• To outline the Magnetic Resonance Imaging (MRI) techniques used for evaluating the postoperative lumbar spine.
• To describe the spectrum of normal and abnormal findings associated with failed back surgery syndrome (FBSS).
• To highlight MRI's role in diagnosing specific complications like disc herniation, epidural scarring, and infection.

Main Methods:

• Review of MRI protocols for postoperative lumbar spine assessment.
• Analysis of imaging findings in patients with persistent low back pain post-surgery.
• Correlation of MRI findings with clinical diagnoses of FBSS causes.

Main Results:

• MRI is highly effective in detecting causes of FBSS, including recurrent disc herniation, epidural scar tissue, spinal stenosis, pseudomeningocele, arachnoiditis, pseudarthrosis, hematoma, and infection.
• Specific MRI sequences and parameters are crucial for accurate diagnosis.
• Abnormal findings are clearly delineated, aiding surgical planning.

Conclusions:

• MRI is the preferred imaging modality for diagnosing the causes of failed back surgery syndrome (FBSS).
• Comprehensive understanding of postoperative MRI findings is essential for effective patient management.
• Early and accurate diagnosis via MRI can guide appropriate therapeutic interventions for persistent low back pain.