title: Magnetic resonance image changes and clinical outcome after microdiscectomy or nucleotomy for ruptured disc.
abstract: Preoperative and postoperative magnetic resonance imaging (MRI) of the lumbar spine was performed on 41 patients treated either microsurgically or with percutaneous nucleotomy for lumbar disc herniation. On the first postoperative day, MRI revealed an edematous mass effect at the level of surgery in 25 (61%) patients. The mass effect caused compression of the anterior dural sac mimicking preoperative disc herniation. After the follow-up of 6 months, the mass effect had disappeared in all patients, and the MRI finding in the operated disc space was that of a prolapse in six (15%) patients and that of a protrusion in 16 (39%) patients. Postoperative scarring was detected in 23 (56%) patients. The amount of the epidural scar tissue was significantly (p = 0.0002) associated with the extent of the early postoperative hemorrhagic changes detected in these patients with MRI. No association was observed between these MRI findings (mass effect, disc herniation, epidural scarring) and the clinical outcome of the patients.
authors.affiliation: Department of Neurosurgery, University of Turku, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Kotilainen
authors.forename: A
authors.initials: A
authors.lastname: Alanen
authors.forename: M
authors.initials: M
authors.lastname: Erkintalo
authors.forename: S
authors.initials: S
authors.lastname: Valtonen
authors.forename: M
authors.initials: M
authors.lastname: Kormano
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000473:pathology; D017587:Diskectomy, Percutaneous / Q000379:methods*; D004487:Edema / Q000473:pathology; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome