Differential diagnosis of post-surgery scars and recurrent lumbar disc herniation in MRI

Background. Spine MR had a significant progress on disc disease diagnosis, reasons of operative treatment failure, and reccurrence of pain.
The aim of the study was to estimate by the use of MRI the causes of pain among patient after discectomy, and to compare them with intraoperative findings.
Material and methods. Between 1994-1998 in the Orthopaedic Clinic in Otwock 42 patients (18 women and 24 men) who underwent discectomy were examined. They suffered from steady back and leg pain. On the base of standard MRI it was not possible to precisely diagnose the cause of pain. A introduction of paramagnetic
Gd-DTPA allowed more precise diagnosis and to ascertain if pain is caused by recurrence of disc hernitation or postoperative scar.
Conclusions.
1. MR was an examination of choice in postoperative diagnosis in disc disease.
2. An examination with Gd-DTPA contrast enhanced allows to differentiate between postoperative scar and recurrent disc herniatation.
3. If postoperative scar is confirmed, the indication for reoperation should be raised very carefully.