The Association Between Preoperative MRI Findings and Surgical Revision Within Three Years After Surgery for Lumbar Disc Herniation

Abstract

Study Design This cohort study was an analysis of prospectively collected data in the DaneSpine Database. Objective: The objective was to determine whether pre-operative magnetic resonance imaging (MRI) findings were associated with the frequency of surgical revision due to recurrent lumbar disc herniation (LDH) within three years after first-time, single-level, simple lumbar discectomy. Summary of Background Data: Because of a risk of poorer outcome in patients receiving revision surgery compared to first-time discectomy, there is a need to identify patients with LDH in risk of surgical revision prior to the primary discectomy. The association between pre-operative MRI findings and revision surgery in patients with LDH has not been thoroughly studied. Methods: Following an inter-observer reliability study pre-operative MRIs were evaluated. Potential predictive variables for surgical revision were evaluated using univariate and multivariate logistic regression analysis. Also, a sum-score of the number of MRI findings at the involved level was assessed. Results: In a study population of 451 operated patients, those who had surgical revision were significantly younger and were significantly less likely to have vertebral endplate signal changes Type 2 (OR 0.36 (95% CI 0.15-0.88)) or more than five MRI findings (OR 0.45 (95% CI 0.21-0.95)) at the involved level than the patients not undergoing surgical revision. Surgical revision was not significantly associated with any other MRI findings. Conclusions: In general, pre-operative MRI findings have a limited explanatory value in predicting surgical revision within three years after first time, single-level, simple lumbar discectomy. Both the single variable VESC Type 2 and a sum-score > 5 MRI findings at the operated level was found to be negatively associated with patients undergoing surgical revision.

Risk factor of residual leg numbness after lumbar microdiscectomy for lumbar disc herniation

“…SROM, Modic change, and degree of disc degeneration has been confirmed by previous studies to be associated with recurrent LDH after lumbar discectomy. [22][23][24][25][26] In this study, we did not find any significant differences between the 2 groups in the surgical segment Modic change and degree of disc degeneration. However, we found that the SROM of the RLN group was significantly higher than that of the Non RLN group (10.3 ± 3.5 vs 8.2 ± 2.9, P < .001).…”

Prognosis Evaluation of MRI Combined with Magnetic Resonance Myelography on Lumbar Disc Herniation after Transforaminal Endoscopic Discectomy

“…This is particularly true for patients with L 4/5 herniation; it is difficult to distinguish nerve root compression on MRI because the initial site of the L5 nerve root is thinner and there is less fat space around the nerve roots after separation from the spinal cord [30]. Besides, MRI is difficult to determine scar compression and postoperative arachnoid adhesion, while MRM has high resolution and can be reconstructed in three dimensions, which can assist clinicians to observe nerve roots from many angles [31] and help to guide postoperative rehabilitation. Some previous studies have also shown that MRM has a certain clinical application value in some orthopedic surgeries.…”

Moderate to Severe Multifidus Fatty Atrophy is the Risk Factor for Recurrence After Microdiscectomy of Lumbar Disc Herniation

“…Most studies have not found an association between sex and rLDH. 21,24,[26][27][28]30,35 However, Oh et al 20 found that female sex is a risk factor for rLDH, while some studies found men to be more likely to experience recurrence than women. [21][22][23] Li et al 23 and Ziegler et al 24 found that younger age is a risk factor for rLDH.…”