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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http://dx.doi.org/10.1148/radiology.182.1.1727310 | DOI Listing |
J Neurosurg Spine
January 2025
2Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland; and.
Objective: Spinal fusion is a commonly performed surgical procedure used to relieve pain, deformity, and instability of various spinal pathologies. Although there have been attempts to standardize spinal fusion assessment radiologically, there is currently no unified definition that also considers clinical symptomology. This review attempts to create a more holistic and standardized definition of spinal fusion.
View Article and Find Full Text PDFArch Bone Jt Surg
January 2024
Scientific Advisory Board, Hospital Británico de Buenos Aires, Buenos Aires, Argentina.
Objectives: Investigate the immediate resonance magnetic image changes undergone by the lumbar canal after indirect decompression and compare them at one-year post-intervention. We also investigate the clinical outcome of indirect decompression at one-year follow-up.
Methods: Imaging changes in patients who underwent indirect lumbar decompression and percutaneous posterior fixation were analyzed with one-year follow-up.
Zhongguo Gu Shang
January 2025
Department of Orthopaedics, Sir Run Run Shaw Hospital, Hangzhou 310016, Zhejiang, China.
Objective: To observe the clinical outcomes of anterior approach for the revision surgery following unsuccessful bone cement augmentation in osteoporotic vertebral compression fractures.
Methods: A total of 10 patients who experienced unsuccessful bone cement augmentation underwent anterior revision surgery between January 2020 and December 2021. There were 2 males and 8 females.
Front Med (Lausanne)
January 2025
Department of Orthopedic, Dianjiang People's Hospital of Chongqing, Chongqing, China.
Lumbar disc herniation (LDH) affects millions globally, with annual healthcare costs exceeding $100 billion in the United States alone, driving increasing interest in minimally invasive radiological interventions as treatment alternatives. This narrative review examines developments in collagenase chemonucleolysis for LDH, integrating a literature analysis with clinical experience. Key advancements include the transition from single-agent to combination therapies, exploration of diverse injection routes, and the progression from C-arm fluoroscopy to multi-slice CT guidance.
View Article and Find Full Text PDFCureus
December 2024
Orthopedics, All India Institute of Medical Sciences (AIIMS) Jammu, Jammu, IND.
Lumbar canal stenosis (LCS) is a common cause of chronic lower back pain in the elderly. Traditionally, open decompression surgery has a prolonged recovery, higher blood loss, and more complications. As a result, there remains no clear consensus on which of these minimally invasive spine surgery (MISS) techniques, including unilateral biportal endoscopy (UBE) and full endoscopy (FE), is the optimal technique for LCS treatment.
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