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Recurrent postoperative sciatica: evaluation with MR imaging and enhanced CT.
L Frocrain1, R Duvauferrier, J L Husson
1Department of Rheumatology, Hôpital Sud, Rennes, France.
Radiology
|February 1, 1989
Summary
Magnetic resonance (MR) imaging is superior to computed tomography enhanced with intravenous iodine injection (ECT) for diagnosing recurrent postoperative sciatica. MR imaging accurately identified surgical causes, while ECT misdiagnosed fibrosis in many cases.
Area of Science:
- Radiology
- Neurosurgery
- Orthopedics
Background:
- Recurrent sciatica after surgery poses diagnostic challenges.
- Accurate diagnosis is crucial for appropriate surgical intervention.
Purpose of the Study:
- To prospectively compare the diagnostic accuracy of Magnetic Resonance (MR) imaging and computed tomography enhanced with intravenous iodine injection (ECT) in patients with recurrent postoperative sciatica.
- To determine the preferred imaging modality for diagnosing the cause of recurrent sciatica.
Main Methods:
- Prospective study involving 80 patients with recurrent postoperative sciatica.
- Comparison of MR imaging and ECT findings against surgical verification.
- Surgical intervention decisions based on imaging results.
Main Results:
- MR imaging demonstrated high diagnostic accuracy, with 44 out of 45 surgically confirmed cases matching MR findings.
- ECT showed lower accuracy, misdiagnosing 19 out of 24 fibrosis cases as recurrent herniations or other disk issues.
- MR imaging guided surgical decisions in 56 patients, while ECT influenced decisions in 21 of those.
Conclusions:
- MR imaging is the investigation of choice for diagnosing the cause of recurrent postoperative sciatica.
- ECT is less reliable for differentiating fibrosis from recurrent disk herniation in this context.