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MRI appearance of adjunct surgical material used in spine surgery
Franziska C S Altorfer1, Reto Sutter2, Mazda Farshad1
1Department of Orthopedic Surgery, Balgrist University Hospital, University of Zurich, Switzerland.
Background Context:
Early postoperative MR images are frequently necessary after spine surgery. The appearance of commonly used adjunct hemostatic agents and dural sealants in MR images has not been systematically evaluated.
Purpose:
The purpose of this experimental study was to systematically analyze and describe the characteristics of the most commonly applied hemostatic agents and dural sealants in spine surgery on early postoperative MR images.
Study Design:
Cadaver Study METHODS: Four commonly applied dural sealants (Duraseal, Bioglue, Tachosil, Tisseel) and five commonly used hemostatic agents (Surgiflo, Bonewax, , Spongostan, Gelfoam, Avitene) were investigated. The experimental setting involved a human cadaver where a standard left-sided laminotomy was performed on nine levels of the thoracolumbar spine, and the materials were separately applied and mixed with fresh blood or water for hemostatic and dural sealants, respectively. The cadaver model was scanned at a 3 Tesla MRI and the imaging findings for all materials were compared to the surrounding tissue and systematically reported.
Results:
All investigated dural sealants and hemostatic agents were distinguishable from the surrounding tissue on MR images with different appearances on the MR sequences. A detailed atlas for the identification of the materials in postoperative spine MRI was established.
Conclusion:
Commonly used hemostatic agents and dural sealants can be successfully identified on early postoperative spine MRI.
Clinical Significance:
Knowledge about MRI appearances of commonly used adjunct surgical materials helps in interpretation of postoperative imaging and supports clinical decision making.
Insights
Commonly used hemostatic agents and dural sealants are identifiable on early postoperative spine MRI scans. This study provides a guide for interpreting these findings, aiding clinical decision-making after spine surgery.
Area of Science:
- Radiology
- Neurosurgery
- Surgical Innovation
Background:
- Postoperative MRI is crucial after spine surgery.
- The MR imaging characteristics of hemostatic agents and dural sealants are not well-documented.
- Accurate interpretation of early postoperative MRI is essential.
Purpose of the Study:
- To systematically analyze and describe the MR imaging features of common hemostatic agents and dural sealants used in spine surgery.
- To create a reference guide for identifying these materials on early postoperative MRI.
- To improve the interpretation of postoperative spine imaging.
Main Methods:
- A human cadaver model underwent a standard laminotomy.
- Four dural sealants and five hemostatic agents were applied.
- Materials were tested with blood or water and imaged using 3 Tesla MRI.
- Imaging findings were compared to surrounding tissues.
Main Results:
- All tested dural sealants and hemostatic agents were distinguishable from surrounding tissues on MRI.
- Each material exhibited unique signal characteristics across different MR sequences.
- A comprehensive atlas for material identification in postoperative spine MRI was developed.
Conclusions:
- Commonly used hemostatic agents and dural sealants are identifiable on early postoperative spine MRI.
- Understanding the MRI appearance of these surgical adjuncts aids in accurate image interpretation.
- This knowledge supports improved clinical decision-making following spine surgery.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...