Fast spin-echo MR assessment of patients with poor outcome following spinal cervical surgery.
OBJECTIVE
The aim of the investigation was to evaluate poor outcome following spinal and cervical surgery.


METHODS
A total of 146 consecutive patients operated with anterior discectomy and fusion (ADF) with the Cloward technique were investigated. Clinical notes, plain radiography, CT, and fast spin-echo (FSE) images were retrospectively evaluated.


RESULTS
Some 30% of the patients had unsatisfactory clinical results within 12 months after surgery; 13% had initial improvement followed by deterioration of the preoperative symptoms, while 14.4% were not improved or worsened. Disc herniation and bony stenosis above, below, or at the fused level were the most common findings. In 45% of patients, surgery failed to decompress the spinal canal. In only 4 patients was no cause of remaining myelopathy and/or radiculopathy found. FSE demonstrated a large variety of pathological findings in the patients with poor clinical outcome after ADF. Postoperatively, patients with good clinical outcome had a lower incidence of pathological changes.


CONCLUSIONS
FSE is considered the primary imaging modality for the cervical spine. However, CT is a useful complement in the axial projection to visualize bone changes.
Wu
W
W
Department of Diagnostic Radiology, University Hospital, Linköping, Sweden.
Thuomas
K A
KA
Hedlund
R
R
Leszniewski
W
W
Vavruch
L
L
D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery; D007738:Kyphosis / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D013123:Spinal Fusion; D013128:Spinal Osteophytosis / Q000175:diagnosis / Q000601:surgery; D013130:Spinal Stenosis / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome