title: Evaluation of degenerative disease of the lumbar spine: MR/MR myelography versus conventional myelography/post-myelography CT.
abstract: To compare the use of magnetic resonance (MR)/MR myelography (MRM) with conventional myelography/post-myelography CT (convM) for detailed surgery planning in degenerative lumbar disease.
  
  
  
  Twenty-six patients with suspected complex lumbar degenerative disease underwent MRM in addition to convM as preoperative workup. Surgery was planned based on convM-as usual at our department. Post hoc, surgical planning was repeated planned again-now based on MRM. Furthermore, the MRM-based planning was performed by six independent neurosurgeons (three groups) of different degrees of specialisation.
  
  
  
  In only 31 % of the patients, post hoc MRM-based planning resulted in the same surgical decision as originally performed, whereas in 69 % (n = 18) a different procedure was indicated. In patients with non-concurring convM- and MRM-based surgical plans, a less extended procedure was the result of MRM in six patients (23 %), a more extended one in five (19 %), and a related to side/level of decompression or nucleotomy different plan in six patients (23 %). In one patient (4 %), the MRM-based planning would have led to a completely different surgery compared to convM. Overall interobserver agreement on the MRM-based planning was substantial.
  
  
  
  Detailed planning of operative procedures for complex lumbar degenerative disease is highly dependent on the image modality used.
authors.affiliation: Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. ehab.shiban@lrz.tum.de.
authors.forename: Ehab
authors.initials: E
authors.lastname: Shiban
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.|Department of Neurosurgery, Universitätsklinik Knappschaftskrankenhaus Bochum, Bochum, Germany.
authors.forename: Marec
authors.initials: M
authors.lastname: von Lehe
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Simon
authors.affiliation: Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.|Department of Neurosurgery, Rheinisch-Westfälische Technische Hochschule (RWTH), Aachen, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Clusmann
authors.affiliation: Institute of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Heinrich
authors.affiliation: Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.|Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Ringel
authors.affiliation: Deptarment of Neuoradiology, University Medical Centre Freiburg, Freiburg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Wilhelm
authors.affiliation: Deptarment of Neuoradiology, University Medical Centre Freiburg, Freiburg, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
authors.affiliation: Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.|Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meyer
authors.affiliation: Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.|Department of Neurosurgery, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.|Department of Neurosurgery, Helios Kliniken, Krefeld, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Stoffel
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008161:Lumbosacral Region / Q000000981:diagnostic imaging* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods*; D055009:Spondylosis / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Lumbar spine; MR imaging; MR myelography; Myelography; Spondylosis