Serial gadolinium-enhanced MR imaging after lumbar disc resection: observation of the affected root

A prospective study was undertaken to clarify the relationship between postoperative morphological/pathological changes in the affected root and the clinical developments after disc resection. Gadolinium-enhanced magnetic resonance (MR) imaging was performed at 1 week, 5 weeks, 3 months, and 6 months after surgery for 28 patients of 34 consecutive patients who underwent single-level disc resection. Enhancement/thickening of the affected root was found to be 100%/89% at 1 week, 50%/57% at 3 months, and 32%/37% at 6 months after surgery. Patients with root enhancement and thickening at 3 and 6 months after surgery had less clinical improvement than patients without it. There was consistent correlation between postoperative clinical developments and nerve root enhancement/thickening in enhanced MR imaging. To use enhanced MR imaging as an evaluation tool after disc surgery might increase the diagnostic accuracy and reduce failed back surgery syndrome.