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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
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MAGNETIC RESONANCE IMAGING IN FAILED BACK SURGERY SYNDROME.

K K Sen1, Amarjit Singh2

  • 1Reader, Department of Radiodiagnosis, Armed Forces Medical College, Pune 411 040.

Medical Journal, Armed Forces India
|August 5, 2017
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Summary
This summary is machine-generated.

Failed back surgery syndrome (FBSS) is a common complication. Gadolinium-enhanced MRI is crucial for diagnosing FBSS causes, guiding effective patient therapy and improving surgical outcomes.

Keywords:
Back painFailed back surgery syndromeGadoliniumMagnetic Resonance Imaging

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Area of Science:

  • Neurosurgery
  • Radiology
  • Spinal Medicine

Background:

  • Failed back surgery syndrome (FBSS) is a frequent and disabling complication following lumbosacral spine surgery, affecting 5-10% of patients.
  • Common causes include wrong level surgery, inadequate techniques, instability, recurrent disc herniation, and lumbosacral fibrosis.

Purpose of the Study:

  • To highlight the importance of understanding FBSS origins and prevention.
  • To emphasize the role of advanced imaging in differentiating pathologies for targeted therapy.
  • To improve the correlation between clinical diagnosis, imaging findings, and patient treatment.

Main Methods:

  • Review of causes and outcomes of FBSS.
  • Evaluation of diagnostic imaging modalities for post-operative lumbosacral spine assessment.
  • Focus on the utility of Gadolinium-enhanced Magnetic Resonance (MR) imaging.

Main Results:

  • Repeated surgery for recurrent disc herniation yields results comparable to initial interventions.
  • Repeated surgery for fibrosis shows lower success rates (30-35%), with 15-20% experiencing symptom worsening.
  • Gadolinium-enhanced MR is identified as the most sensitive and specific imaging tool for evaluating post-operative FBSS.

Conclusions:

  • Accurate differentiation of FBSS pathologies through imaging is essential for selecting appropriate therapies.
  • Enhanced understanding of FBSS etiology and improved imaging interpretation can optimize patient management.
  • Gadolinium-enhanced MR imaging is critical for neuro-radiological evaluation in FBSS patients.