Evaluation of the postoperative lumbar spine

Herrera, Isabel Herrera; Presa, Raquel Moreno de la; Gutiérrez, R. González; Ruiz, E. Bárcena; Benassi, Juan Manuel Garcia

doi:10.1016/j.rxeng.2011.12.002

Cited by 18 publications

(13 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On CT images, epidural fibrosis shows a lower attenuation of 50 to 75 HU, whereas recurrent disc hernia shows an attenuation of 90 to 120 HU. 13 Thus, low HU values of the deltoid ligament in the CAI group and elderly participants could be explained by the degeneration of ligaments.…”

Section: Discussionmentioning

confidence: 91%

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

et al. 2021

View full text Add to dashboard Cite

Background: Rotational ankle instability (RAI) is associated with the faster onset of severe ankle osteoarthritis via dysfunction of the anterior talofibular ligament, calcaneofibular ligament, and deltoid ligament. No specific clinical examination is available for RAI, and diagnostic imaging has limitations in evaluating ligament degradation. This study investigated the deltoid ligament degeneration using Hounsfield unit (HU) values on computed tomography (CT) images. Methods: Patients were enrolled in this retrospective analysis if they had undergone magnetic resonance imaging (MRI) and CT scans of the ankle. The chronic ankle instability (CAI) group comprised 20 ankles with CAI (9 men, 11 women; mean age, 28.7 years) and the control group comprised 28 ankles (16 men, 12 women, mean age, 41.3 years). The average HU values of the deep posterior tibiotalar ligament (dPTL) that constitutes the deltoid ligament were measured on coronal CT images, and MRI results were used as a reference. All patients were subdivided based on the MRI findings of dPTL injury such as fascicular disruption, irregularity, and the loss of striation. Results: A strong negative correlation was identified between age and HU values for all patients (Spearman ρ = −0.63; P < .001). The mean HU values of the dPTL for participants aged <60 years were 81.0 HU for the control group (21 ankles) and 69.5 HU for the CAI group ( P = .0075). No significant differences in the HU values were observed for the dPTL among the MRI subgroups. Conclusion: In addition to the conventional imaging examination such as stress radiographs and MRI, HU measurements of CT images could be useful for quantitatively and noninvasively evaluating degenerative changes in the deltoid ligament for CAI patients to assist the diagnosis of RAI. Level of Evidence: Level III. case-control study.

show abstract

Section: Discussionmentioning

confidence: 91%

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

et al. 2021

View full text Add to dashboard Cite

show abstract

“…수술 후 합병증은 수술 후 시간에 따라 다양하게 나타날 수 있는데, 초기 수술 후 합병증에는 적절하지 않은 수술기구의 위치(instrument malposition), 수술 후 액체 저류(fluid collection) 및 감염(infection) 등이 있고 중장기적인 합병증으로 수술 기구 주변의 골용해, 융합 실패(failure of fusion), 인접한 척추 분절의 질환(adjacent segment disease; 이하 ASD), 경막외 섬유화(epidural fibrosis) 등이 있다( 7 8 9 10 ). 이러한 다양한 합병증이 있을 수 있기 때문에 척추 수술 후 합병증을 정확히 진단하기 위해서는 수술 후 시간에 따른 다양한 합병증을 이해하고 영상학적 특징을 아는 것이 중요하다.…”

Section: 서론unclassified

“…이를 통해 수술 기구의 적절한 위치 및 인접 분절의 퇴행성 변화를 확인할 수 있으며, 이러한 정보는 수술 결과의 평가에 도움을 준다( 12 ). 일반적으로 anteroposterior, lateral, oblique, dynamic view (flexion, extension position)를 촬영하며, dynamic view를 통해서는 척추 수술 후의 골 정렬 상태를 파악하고 척추후궁절제(laminectomy) 상태의 환자에 척추전방전위증(spondylolisthesis)이 있을 경우 불안정(instability)을 평가하는데 도움을 줄 수 있다( 4 8 ).…”

Section: 척추 수술 후 영상 검사unclassified

Imaging Evaluation of Early and Long-Term Complications Associated with the Postoperative Spine

Park,

Kim,

Chai

et al. 2024

J Korean Soc Radiol

View full text Add to dashboard Cite

척추 수술의 빈도 증가와 더불어 radiography, CT, MRI 등의 의료 영상 촬영 건수도 증가하고 있으며, 이와 관련된 영상 판독의 중요성이 점점 더 커지고 있다. 본 논문에서는 척추 수술 후 발생 가능한 다양한 합병증을 이해하고, 이를 정확하고 효과적으로 진단하는 영상 검사의 중요 소견에 대해 다루고자 한다. 특히, 수술 후 초기 및 중장기 합병증을 구분하여, 각 시기별 특징적인 영상 소견을 자세히 설명한다. 척추 수술 후 초기 합병증으로는 부적절한 수술 기구 배치(instrument malposition), 장액종(seroma), 혈종(hematoma), 거짓수막류(pseudomeningocele), 수술 주변 감염(infection) 등이 있으며, 중장기 합병증으로는 수술 기구 주변의 골용해(osteolysis), 융합 실패(failure of fusion), 인접 분절 질환(adjacent segment disease), 경막외 섬유화 또는 흉터 조직(epidural fibrosis or scar) 형성 등이 포함된다. 이러한 척수 수술 후 발생하는 합병증 관련 영상 평가에 대한 정확한 이해는 척추 수술 후 합병증을 적시에 정확하게 진단하여 효과적인 환자 치료에 기여할 것이다.

show abstract

“…Determining the amount of time elapsed after surgery is particularly important, since findings in the immediate postoperative period need to be evaluated with caution. [ 6 , 7 ]…”

Section: Introductionmentioning

confidence: 99%

“…Determining the amount of time elapsed after surgery is particularly important, since findings in the immediate postoperative period need to be evaluated with caution. [6,7] Currently, immediate postoperative MRI is not considered to be the standard evaluation approach in many spine centers based on research stating that immediate postoperative MRI results are often similar to those of preoperative MRI in symptomatic and asymptomatic patients. [8] Boos et al reported that MRI cannot provide a causal explanation for postoperative pain, as a majority of asymptomatic patients (63%) had findings comparable with those in symptomatic patients.…”

Section: Introductionmentioning

confidence: 99%

Immediate postoperative lumbar spine magnetic resonance imaging: Correlation with postoperative pain in lumbar microdiscectomy

et al. 2022

View full text Add to dashboard Cite

Magnetic resonance imaging (MRI) has been extensively used in the management of patients with a herniated lumbar disc. Nevertheless, immediate postoperative MRI has not become a standard procedure, with limited research suggesting that the findings are often similar to preoperative MRI in both symptomatic and asymptomatic patients. This study aimed to determine the benefits of immediate postoperative MRI in patients with or without postoperative symptoms and its correlation with these symptoms. A total of 172 patients who underwent lumbar spine microdiscectomy at our institution between 2014 and 2021 were included. Patients who had previous spinal surgery and lumbar fusion were excluded. Patient data were collected from medical records. MRI was performed 3 days after surgery and assessed by 2 neurosurgeons to minimize bias. Immediate postoperative MRI results showed dural sac compression or foraminal stenosis in 29 patients (16.86%), of which 10 had postoperative pain and 19 were pain free. Among the 143 patients (83.14%) without these findings on MR imaging, 38 had postoperative pain. Immediate postoperative MRI did not correlate with postoperative pain (P = .421/.357). Intraoperative bleeding and the Charlson comorbidity index (CCI) showed significant correlations with postoperative pain (P = .018 and .002, respectively). In a multivariate analysis, intraoperative blood loss and CCI independently correlated with postoperative pain (P = .001 and .001, respectively). Based on our findings, intraoperative blood loss and CCI appear to be the factors that may predict the persistence of postoperative pain, despite normal findings on MRI.

show abstract

Evaluation of the postoperative lumbar spine

Cited by 18 publications

References 25 publications

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

Imaging Evaluation of Early and Long-Term Complications Associated with the Postoperative Spine

Immediate postoperative lumbar spine magnetic resonance imaging: Correlation with postoperative pain in lumbar microdiscectomy

Contact Info

Product

Resources

About