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Magnetic resonance imaging in patients with progressive myelopathy following spinal surgery
E Avrahami1, R Tadmor, D F Cohn
1Department of Radiology, Tel-Aviv University Sackler School of Medicine, Israel.
Abstract:
Thirty one patients with insidious progressive myelopathy 2 to 8 years following surgery of the cervical spine were subjected to magnetic resonance imaging (MRI). In 15 patients operated on for vascular malformations or intramedullary tumours, syringomyelia and cystic lesions of the spinal cord were shown. Seven of these patients also showed a combination of a recurrent tumour and spinal atrophy. Out of 16 patients who had surgery for herniated disc or spinal stenosis of the cervical spine, four had syringomyelia and 12 had spinal cord atrophy. There was no syringomyelia in the 12 patients submitted to MRI prior to surgery.
Insights
Magnetic resonance imaging (MRI) revealed that cervical spine surgery can lead to myelopathy, including syringomyelia and spinal cord atrophy. Early MRI may help detect these post-surgical complications.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Progressive myelopathy can occur years after cervical spine surgery.
- Previous studies have explored post-surgical complications, but long-term sequelae require further investigation.
Purpose of the Study:
- To investigate the incidence and types of spinal cord lesions in patients with myelopathy following cervical spine surgery.
- To correlate MRI findings with the type of initial cervical spine surgery.
Main Methods:
- Magnetic resonance imaging (MRI) was performed on 31 patients with insidious progressive myelopathy.
- Patients had undergone cervical spine surgery 2 to 8 years prior.
- Surgical history included vascular malformations, intramedullary tumors, herniated discs, or spinal stenosis.
Main Results:
- Syringomyelia and cystic lesions were observed in 15 patients operated on for vascular malformations or tumors.
- Seven of these patients also had recurrent tumors and spinal atrophy.
- Among 16 patients operated on for disc herniation or stenosis, 4 had syringomyelia and 12 had spinal cord atrophy.
Conclusions:
- Cervical spine surgery is associated with delayed myelopathy, including syringomyelia and spinal cord atrophy.
- The type of lesion may differ based on the initial surgical indication.
- Pre-operative MRI in 12 patients showed no syringomyelia, suggesting post-surgical development.