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Immediate postoperative MRI findings after lumbar decompression surgery: Correlation of imaging features with clinical outcome

Immediate postoperative MRI findings after lumbar decompression surgery: Correlation of imaging features with clinical outcome

Authors :
Sang Min Park
Bo Ram Kim
Joong Mo Ahn
Yusuhn Kang
Eugene Lee
Joon Bum Yeo
Heung Sik Kang
Joon Woo Lee
Source :
Journal of Clinical Neuroscience. 89:365-374
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

An understanding of the common MRI findings observed after decompression surgery is important. However, to date, no study addressing this has been published. The aim of this study was to analyze and describe the immediate postoperative MRI findings after lumbar decompression surgery. We retrospectively analyzed the immediate postoperative MRIs of 121 consecutive patients who underwent lumbar decompression surgery between July 2017 and June 2018. Changes in stenosis at the decompressed and adjacent levels, epidural fat edema, epidural and subdural fluid collections, nerve root swelling, facet joint effusions, intervertebral disc signal, and paravertebral muscle edema were correlated with clinical characteristics. Both groups had reduced central canal stenosis postoperatively (p 0.001) but worsened stenosis at adjacent segments. Fluid collection, hemorrhagic or non-hemorrhagic, at the laminectomy site was the commonest finding (one-level: 73.8%, two-level: 88.5%), with a higher percentage of severe central canal compromise in the two-level decompression group (p = 0.003). Other postoperative MRI findings, such as epidural fat edema, nerve root swelling, subdural fluid collection, and facet joint effusion, were noted without statistical significance. In conclusion, even with successful decompression for lumbar canal stenosis, increased central canal stenosis at adjacent segments is common on immediate postoperative MRI scans, showing no statistically significant correlation with the immediate postoperative outcome. Postoperative fluid collection at the laminectomy site is the commonest imaging finding, and higher rates of hemorrhagic fluid and more severe central canal compromise occur in two-level decompression, but rarely cause clinical problems.

Details

ISSN :
09675868
Volume :
89
Database :
OpenAIRE
Journal :
Journal of Clinical Neuroscience
Accession number :
edsair.doi.dedup.....47283c7c756299a4345ee0f41e8572d3
Full Text :
https://doi.org/10.1016/j.jocn.2021.05.045