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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
- 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.
- Subjects :
- Epidural Space
musculoskeletal diseases
medicine.medical_specialty
Nerve root
medicine.medical_treatment
Facet joint
03 medical and health sciences
Postoperative Complications
Spinal Stenosis
0302 clinical medicine
Lumbar
Epidural hematoma
Physiology (medical)
medicine
Humans
Intervertebral Disc
Aged
Lumbar Vertebrae
medicine.diagnostic_test
business.industry
Laminectomy
Lumbar spinal stenosis
Magnetic resonance imaging
General Medicine
Middle Aged
Decompression, Surgical
medicine.disease
Magnetic Resonance Imaging
Surgery
Stenosis
medicine.anatomical_structure
Neurology
030220 oncology & carcinogenesis
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
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