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Related Experiment Videos

MRI after successful lumbar discectomy

J W Van Goethem1, E Van de Kelft, I G Biltjes

  • 1Department of Radiology, University of Antwerp, Edegem, Belgium.

Neuroradiology
|May 1, 1996
PubMed
Summary

Postoperative lumbar discectomy MRI scans show contrast enhancement along the surgical tract in all patients at 6 weeks and 6 months. Epidural scarring is minimal by 6 months, but recurrent disc herniation occurs in 20%.

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Area of Science:

  • Radiology
  • Neurosurgery
  • Orthopedics

Background:

  • Lumbar discectomy is a common surgical procedure.
  • Postoperative Magnetic Resonance Imaging (MRI) is crucial for evaluating surgical outcomes.
  • Establishing normal MRI findings after successful surgery is essential for accurate diagnosis.

Purpose of the Study:

  • To define the typical range of MRI findings following successful lumbar discectomy.
  • To differentiate expected postoperative changes from complications like recurrent disc herniation.

Main Methods:

  • Prospective study of 34 patients with excellent clinical outcomes post-lumbar discectomy.
  • Serial MRI examinations at 6 weeks and 6 months using T1-weighted (pre- and post-gadolinium) and T2-weighted sequences.
  • Evaluation of contrast enhancement, surgical tract changes, dural sac mass effect, and nerve root enhancement.

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Main Results:

  • All patients exhibited contrast enhancement along the surgical tract at both 6 weeks and 6 months.
  • Minimal dural sac mass effect from epidural scar was observed at 6 months.
  • Recurrent disc herniation occurred in 20% of patients.
  • Nerve root enhancement was seen in 20% at 6 weeks, resolving by 6 months, and sometimes associated with recurrence.

Conclusions:

  • Postoperative MRI findings, including contrast enhancement and minimal epidural scarring, are common even in asymptomatic patients after successful lumbar discectomy.
  • Interpreting postoperative MRI requires careful consideration as findings similar to failed back surgery syndrome can be present.
  • These findings help establish a baseline for normal postoperative MRI, aiding in the detection of true complications.