Reherniation and reoperation rates of 4.5%-36% are reported in canine patients treated for intervertebral disc herniation (IVDH). Decision-making for surgical reintervention can prove challenging, especially since common postoperative changes are poorly described on MRI. The purpose of this single-center, retrospective, descriptive study was to describe the MRI characteristics of the surgical site in dogs treated for thoracolumbar IVDH and presenting for ongoing or recurrent neurological signs. Twenty-one patients were included for a total of 42 MRI studies. Chondrodystrophic breeds, specifically Dachshunds, were overrepresented. Mean number of days between surgery and second MRI was 335 (range 2-1367). Metallic susceptibility artifacts were seen in seven of 21 cases (33%), but these were limited in extent, spanning on average 1.3 vertebral bodies. In 11 cases, spinal cord compression suspected to be clinically significant was found at the surgical site; the extradural compressive material consisted of intervertebral disc material only, or a combination of intervertebral disc material and hematoma or inflammatory changes in 10 cases, and a displaced articular process and fibrous tissue in one case. The latter is a newly described complication of mini-hemilaminectomies. Paravertebral soft tissue changes and vertebral new bone formation varied according to the postoperative stage at which the patients were imaged. The results of this study supported the use of MRI as a diagnostic modality for spinal imaging following IVDH surgery, and showed that the presence of extradural disc material at a spinal surgical site is common along with various vertebral and paravertebral changes.
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http://dx.doi.org/10.1111/vru.13143 | DOI Listing |
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Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, 8thHa'Aliya Hashniya st, Haifa, Israel.
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Cedars-Sinai Medical Centre, Los Angeles, USA.
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Department of Surgery, Duke University, 2301 Erwin Road, HAFS Building 7th floor 7665A, Durham, NC, 27710, USA.
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Clinica Chirurgica, Department of Experimental and Clinical Medicine, Section of Surgical Sciences, Polytechnic University of Marche, Ancona, Italy.
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Division of Minimally Invasive and Bariatric Surgery, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
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