Does Postcontrast MR Enhancement in Lumbar Disk Herniation Have Prognostic Value?

The Use of Magnetic Resonance Imaging to Predict the Clinical Outcome of Non-Surgical Treatment for Lumbar Interverterbal Disc Herniation

“…However, the interval between injection and surgery was only 1.67 months (range: 7 days to 9 months) for the non-responders, suggesting that the shortterm outcome of ESI is important for the future management of patients with disc herniation. Finally, although there have been reports on the prognostic value of contrast-enhanced MRI (13, 14) and also reports on the morphological changes observed on follow-up MRI after conservative management of lumbar disc herniation (11, 15), we can not evaluate these since contrast enhancement was not routinely performed, and the follow-up MRIs were obtained in only a few cases.…”

“…Using MRI, Komori et al have reported that large sequestered or extruded disc herniations frequently decreased in size after conservative treatment (16). In a study examining the prognostic value of postcontrast MR enhancement in lumbar discs, Gallucci et al have found that the high signal intensity of the disc fragment on the T2-weighted images were related to a reduction of the disc fragment itself (13). In the present study, there was no significant difference between the responders and non-responders in terms of the type, hydration or size of the herniated disc.…”

The Effect of Lumbar Flexion and Extension on Disc Contour Abnormality Measured Quantitatively on Magnetic Resonance Imaging

“…41,43 Furthermore, reductions in the dimensions of posterior disc contour abnormality as large as 35% were observed in this study, which is more than the 20% reported over periods varying between 10 weeks to 3 years of conservative treatment using qualitative measures or quantitative measures with unknown reliability. 3,10,[53][54][55][56][57] Thus, the variations in posterior disc contour abnormality quantified in this study are substantial.…”

Degenerative disorders of the spine

“…In a perspective study by our group, the herniated disk that displayed a high signal intensity on T2-weighted sequences regressed spontaneously in 83% of cases, while the free fragment disappears spontaneously within six months in 100% of the cases studied. Protrusion or bulging tends to be more stable from both anatomical and clinical points of view [14,[20][21][22][23][24].…”