Acta Neurochirurgica

, Volume 139, Issue 3, pp 169–175 | Cite as

Early postoperative MRI findings following surgery for herniated lumbar disc

  • R. Floris
  • A. Spallone
  • T. Y. Aref
  • A. Rizzo
  • A. Apruzzese
  • M. Mulas
  • G. Simonetti
Clinical Articles


MRI is routinely used in the evaluation and management of patients with failed back surgery syndrome (FBSS). However, its value is unclear in the early detection of signs that can negatively affect the later course of surgical cases. The purpose of the present study is to describe the MR images of early postoperative MRI at 3 days in 30 unselected patients who underwent lumbar microdiscectomy, and to correlate the findings with follow up MRI at 8 weeks and with final outcome. The findings are correlated with literature data. Early postoperative MRI findings were consisting of pseudohernia in 24 patients (80%), annular rent in 23 patients (80%), and other non-specific postoperative findings. On the late MRI the pseudohernia persisted in 12 patients (50%), the annular rent in 4 patients (15%) and asymptomatic pseudo-spondylodiscitis was apparent in 3 patients (10%) as was a case of true spondylodiscitis. Therefore, early postoperative findings have limited value in the management of patients after surgery for lumbar disc herniation, since the images were not correlated with the immediate clinical course after surgery nor with the late radiological and clinical outcome. The evident imaging changes in the early postoperative period after lumbar disc surgery limit the accuracy of the interpretation of MRI examinations.


MRI spine intervertebral discs surgery 


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  1. 1.
    Boden SD, Davis DO, Dina TS, Parker CP,et al (1992) Contrast-enhanced MR imaging performed after successful lumbar disc surgery: prospective study. Radiology 182: 59–64PubMedGoogle Scholar
  2. 2.
    Boden SD, Davis DO, Dina TS, Summer JL, Wiesel SW (1992) Postoperative discitis: distinguishing early MR imaging findings from normal postoperative disc space changes. Radiology 184: 765–771PubMedGoogle Scholar
  3. 3.
    Braun IF, Hoffman JC, Davis PC, Landman JA, Tindall GT (1985) Contrast enhancement in CT differentiation between recurrent disc herniation and postoperative scar: prospective study. AJR 145: 785–790PubMedGoogle Scholar
  4. 4.
    Bundschuh CV, Modic MT, Ross JS, Masaryk TJ, Bohlman H (1988) Epidural fibrosis and recurrent disc herniation in the lumbar spine: MR imaging assessment. AJR 150: 923–932PubMedGoogle Scholar
  5. 5.
    Burton CV, Kirkaldy-Willis WH, Yong-Hing F, Heithall KB (1981) Causes of failure of surgery on the lumbar spine. Clin Orthop 157: 191–199PubMedGoogle Scholar
  6. 6.
    Cavanagh S, Stevens J, Johnson JR (1993) High-resolution MRI in the investigation of recurrent pain after lumbar discectomy. J Bone Joint Surg 75B: 524–528Google Scholar
  7. 7.
    Cervellini P, Curri D, Volpin L, Bernardi L, Pinna V, Benedetti A (1988) Computed tomography of epidural fibrosis after discectomy: a comparison between symptomatic and asymptomatic patients. Neurosurgery 23: 710–713PubMedGoogle Scholar
  8. 8.
    Davis CH (1982) Extradural spinal cord and nerve root compression from benign lesions in the lumbar area. In: Youmans JR (ed) Neurosurgical surgery, 2nd Ed. Saunders, Philadelphia, pp 2535–2561Google Scholar
  9. 9.
    Deutsch AL, Howard M, Dawson EG, Goldstein TB, Mink JH, Zeegen EH, Delamarter RB (1993) Lumbar spine following successful surgical discectomy. Magnetic resonance imaging features and implications. Spine 18: 1054–1060PubMedGoogle Scholar
  10. 10.
    Fandiño J, Botana C, Viladrich A, Gomez-Bueno J (1993) Reoperation after lumbar disc surgery: results in 130 cases. Acta Neurochir (Wien) 123: 102–104Google Scholar
  11. 11.
    Firoozina H, Kircheff II, Rafii M, Golimbu G (1987) Lumbar spine after surgery: examination with intravenous contrast enhanced CT. Radiology 163: 221–226PubMedGoogle Scholar
  12. 12.
    Heilbronner R, Fankhauser H, Schnyder P, De Tribolet N (1991) Computed tomography of the postoperative intervertebral disc and lumbar spinal canal: serial long-term investigation in 19 patients after successful operation for lumbar disc herniation. Neurosurgery 29(1): 1–7PubMedGoogle Scholar
  13. 13.
    Hochhauser L, Kieffer SA, Cacayorin ED, Petro GR, Teller WF (1988) Recurrent postdiscectomy low back pain: MR-surgical correlation. AJR 151: 755–760PubMedGoogle Scholar
  14. 14.
    Hueftle MG, Modic MT, Ross JS, Masaryk TJ,et al (1988) Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology 169: 817–824PubMedGoogle Scholar
  15. 15.
    Kotilainen E, Alanen A, Erkintalo M, Helenius H, Valtonen S (1994) Postoperative hematomas after successful lumbar microdiscectomy or percutaneous nucleotomy: a magnetic resonance imaging study. Surg Neurol 41: 98–105PubMedGoogle Scholar
  16. 16.
    Kotilainen E, Alanen A, Erkintalo M, Valtonen S, Kormano M (1994) Magnetic resonance imaging changes and clinical outcome after microdiscectomy or nucleotomy for ruptured disc. Surg Neurol 41: 432–440PubMedGoogle Scholar
  17. 17.
    Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disc disease. Radiology 168: 177–186PubMedGoogle Scholar
  18. 18.
    Montaldi S, Fankhauser H, Schnyder P, De Tribolet N (1988) Computed tomography of the post-operative intervertebral disc and lumbar spinal canal: investigation of twenty-five patients after successful operation for lumbar disc herniation. Neurosurgery 22(6): 1014–1022PubMedGoogle Scholar
  19. 19.
    Ross JS, Masaryk TJ, Modic MT, Bohlman H,et al (1987) Lumbar spine: postoperative assessment with surface-coil MR imaging. Radiology 164: 851–860PubMedGoogle Scholar
  20. 20.
    Ross JS, Masaryk TJ, Schrader M, Gentili A, Bohlman H, Modic MT (1990) MR imaging of the postoperative lumbar spine: assessment with gadopentate dimeglumine. AJNR 11: 771–776PubMedGoogle Scholar
  21. 21.
    Ruscalleda J (1992) Postoperative spine. Rivista di Neuroradiologia 5: 93–100Google Scholar
  22. 22.
    Spallone A, Martino V, Floris R (1993) The role of early postoperative CT-scan following surgery for herniated lumbar disc. Acta Neurochir (Wien) 123: 52–56Google Scholar
  23. 23.
    Tullberg T, Grane P, Rydberg J, Isacson J (1994) Comparison of contrast-enhanced computed tomography and gadolinium-enhanced magnetic resonance imaging one year after lumbar discectomy. Spine 19: 183–188PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • R. Floris
    • 1
  • A. Spallone
    • 2
  • T. Y. Aref
    • 1
  • A. Rizzo
    • 2
  • A. Apruzzese
    • 3
  • M. Mulas
    • 3
  • G. Simonetti
    • 1
  1. 1.Department of RadiologyUniversity of Rome “Tor Vergata”, Hospital S. EugenioItaly
  2. 2.Department of NeurosurgeryUniversity of Rome “Tor Vergata”, Hospital S. EugenioItaly
  3. 3.IRCCS S. LuciaRomaItaly

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