Document Detail


Defining the use of gadolinium enhanced MRI in the assessment of the postoperative lumbar spine.
MedLine Citation:
PMID:  9240706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective study of case notes and magnetic resonance imaging (MRI) examinations was performed to assess the value of gadolinium enhanced MRI in the investigation of persistent back pain following lumbar spine surgery in patients who have not had a discectomy for disc herniation. Gadolinium enhancement is commonly used during MRI of patients with persistent back pain following surgery and epidural scar is frequently identified in patients who have had a previous discectomy. However the value of gadolinium enhancement in patients without previous discectomy had not been addressed. One hundred sets of case notes were examined and 24 patients with an accurate history of previous lumbar spine surgery without discectomy were identified. The nature of surgery and the MRI findings were correlated in these patients. Epidural enhancement was identified at seven sites in six patients (engorged epidural venous plexus, three; enhancement adjacent to degenerate discs, two; enhancement adjacent to facets, two). In no case was epidural scarring involving nerve roots identified. We conclude that routine gadolinium enhancement is unnecessary in patients without a history of discectomy for disc herniation.
Authors:
L S Wilkinson; E Elson; A Saifuddin; A O Ransford
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical radiology     Volume:  52     ISSN:  0009-9260     ISO Abbreviation:  Clin Radiol     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-08-21     Completed Date:  1997-08-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  530-4     Citation Subset:  IM    
Affiliation:
Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Contrast Media*
Diskectomy / adverse effects
Epidural Space / pathology
Female
Fibrosis
Gadolinium DTPA
Humans
Laminectomy
Low Back Pain / etiology*
Lumbar Vertebrae / surgery*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Organometallic Compounds / diagnostic use*
Pentetic Acid / analogs & derivatives*,  diagnostic use
Recurrence
Retrospective Studies
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 67-43-6/Pentetic Acid; 80529-93-7/Gadolinium DTPA
Comments/Corrections
Comment In:
Clin Radiol. 1997 Dec;52(12):964   [PMID:  9413978 ]

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