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The Association Between Preoperative MRI Findings and Surgical Revision Within Three Years After Surgery for Lumbar

Dorthe Schoeler Ziegler1,2, Leah Carreon1,2, Mikkel Oesterheden Andersen1,2

  • 1Spine Surgery and Research, Spine Center of Southern Denmark - part of Lillebaelt Hospital, Middelfart, Denmark.

Spine
|May 17, 2019
PubMed
Abstract

Insights

Preoperative MRI findings have limited predictive value for surgical revision after lumbar disc herniation surgery. Younger patients and those with fewer MRI findings were less likely to need revision, suggesting limited utility for routine prediction.

Area of Science:

  • Neurosurgery
  • Radiology
  • Orthopedics

Background:

  • Revision surgery for lumbar disc herniation (LDH) is associated with poorer outcomes.
  • Identifying patients at risk for revision surgery before primary discectomy is crucial.
  • The predictive value of preoperative MRI findings for revision surgery in LDH has been underexplored.

Purpose of the Study:

  • To investigate the association between preoperative magnetic resonance imaging (MRI) findings and the likelihood of surgical revision for recurrent LDH.
  • To assess these associations within 3 years following first-time, single-level, simple lumbar discectomy.

Main Methods:

  • Analysis of prospectively collected data from the DaneSpine Database.
  • Interobserver reliability study of preoperative MRIs.
  • Univariate and multivariate logistic regression to evaluate predictive variables for surgical revision.

Main Results:

  • Surgical revision was associated with younger patient age.
  • Patients undergoing revision were less likely to have vertebral endplate signal changes Type 2 (OR 0.36) or more than five MRI findings (OR 0.45).
  • No significant association was found between surgical revision and other specific MRI findings.

Conclusions:

  • Preoperative MRI findings generally offer limited explanatory value for predicting surgical revision after lumbar discectomy.
  • Vertebral endplate signal changes Type 2 and a high number of MRI findings (>5) were negatively associated with revision surgery.
  • These specific MRI indicators may help identify patients less likely to require revision.

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