title: MRI after successful lumbar discectomy.
abstract: Our aim was to establish the normal range of MRI findings after successful lumbar discectomy. We prospectively examined 34 consecutive patients with an excellent clinical outcome by MRI 6 weeks and 6 months after surgery. All examinations included sagittal and axial spin-echo (SE) T1-weighted images before and after intravenous gadolinium-DTPA and fast SE T2-weighted images. Contrast enhancement along the surgical tract was seen in all patients 6 weeks and 6 months after surgery. After 6 months minimal or no mass effect on the dural sac by epidural scar was seen. In 20% of patients there was recurrent disc herniation, with mass effect. Enhancing nerve roots were seen in 20% of patients 6 weeks postoperatively, and half of these were associated with recurrent disc herniation at the same side. None of these patients still showed nerve root enhancement 6 months after surgery. Postoperative MRI studies must be interpreted with great care since the features described in the failed back surgery syndrome are also found, to some extent, in asymptomatic postoperative patients.
authors.affiliation: Department of Radiology, University of Antwerp, Edegem, Belgium.
authors.forename: J W
authors.initials: JW
authors.lastname: Van Goethem
authors.forename: E
authors.initials: E
authors.lastname: Van de Kelft
authors.forename: I G
authors.initials: IG
authors.lastname: Biltjes
authors.forename: B A
authors.initials: BA
authors.lastname: van Hasselt
authors.forename: L
authors.initials: L
authors.lastname: van den Hauwe
authors.forename: P M
authors.initials: PM
authors.lastname: Parizel
authors.forename: A M
authors.initials: AM
authors.lastname: De Schepper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000175:diagnosis; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007405:Intervertebral Disc Displacement / Q000473:pathology* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D011184:Postoperative Period; D011446:Prospective Studies; D012008:Recurrence; D013126:Spinal Nerve Roots / Q000473:pathology
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA