Differential diagnosis between recurrent disc herniation and granulation tissue after lumbar disc herniation Surgery: Qualitative analysis on MRI scans.

Background: Recurrence of disc herniation is a prevalent late-term complication among patients surgically treated for lumbar disc herniation. Differential diagnosis between recurrent disc herniation and granulation tissue can be achieved through signal intensity measurements on T2-weighted MRI examinations. This study aims to examine cases operated on for recurrence of lumbar disc herniation, assessing those presenting with either disc recurrence or granulation tissue. The objective is to demonstrate that differential diagnosis can be facilitated through signal intensity value measurements and radiological findings in MRI examinations of patients with disc herniation recurrence and granulation tissue.

Methods: Analysis involved reviewing lumbar MRI T2 sequences of patients operated on with a presumptive diagnosis of lumbar disc herniation recurrence. Mean T2 signal intensity values in preoperative MRI images of cases with disc herniation recurrence and granulation tissue were examined and recorded on the Picture Archiving and Communication System. Mean T2 signal intensity values of recurrent disc herniation and granulation tissue were then compared.

Results: Among the patients who underwent surgery, disc herniation recurrence was observed in 135 cases, while granulation tissue was found in 12 patients (8.89 %). The preopreative mean T2 signal intensity value for disc herniation was recorded as 54.82 ± 2.42, whereas the mean T2 signal intensity value for granulation tissue was 205.96 ± 5.62.

Conclusions: T2 sequences in MRI examinations offer the clearest evaluation of disc herniations. Mean T2 signal intensity value measurements conducted on the PACS system can aid in differentiating between recurrent disc herniation and granulation tissue. These findings serve to inform surgical protocols during the preoperative phase.