AI Article Synopsis

  • A study looked at MRI findings in 15 patients who had successful lumbar disk surgery and no longer had symptoms.
  • The imagery showed that enhancement in facet joints and paraspinal muscles decreased over time, while nerve root enhancement lessened and disappeared by 6 months.
  • Despite patients feeling better, some still had areas on imaging that could mimic a disk recurrence, highlighting the need for careful interpretation of MRIs in the months following surgery.

Article Abstract

A prospective study was undertaken to establish the normal spectrum and timing of gadolinium-enhanced magnetic resonance (MR) imaging findings in 15 patients who had resolution of symptoms after successful lumbar disk surgery. Enhancement of the facet joints (in 88% of disk levels) and paraspinal muscles (100%) decreased gradually after surgery. Enhancement of the decompressed nerve root tracked proximally toward the conus medullaris in 62% at 3 weeks and was absent in all by 6 months postoperatively. Areas of intermediate signal intensity with peripheral enhancement and mass effect were seen on T1-weighted images at the site of the original disk herniation in 38% at 3 weeks and 12% at 3 months, despite complete relief of leg pain. These results reveal that even in successfully treated (asymptomatic) patients, residual mass effect on the neural elements may frequently simulate a recurrent or residual disk fragment. There is an orderly progression of imaging changes during the first 6 months after lumbar surgery that limits the interpretation of MR examinations during that period.

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Source
http://dx.doi.org/10.1148/radiology.182.1.1727310DOI Listing

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