MRI of Postoperative Lumbar Spine after Surgery: Assessment of Recurrent Herniated Disk

Abstract

Failed back surgery syndrome is a rather frequent entity in the postoperative setting of herniated nucleus pulposus (HNP) removal. Various conditions may be involved in the recurrent pain; these include persistent or recurrent HNP and pathologic scarring, which must be differentiated as reoperation gives opposite results. Radiologic assessment of these patients is one of the most difficult problems in neuroradiology. To date, plain computed tomography (CT) followed by CT after IV injection of contrast material has been the most widespread modality, although a significant number of false diagnoses result (Braun et al. 1985). Some institutions perform diskography. Recently, magnetic resonance imaging (MRI) with injection of contrast material (Gd-DOTA) has been reported (Hueftle et al. 1988), giving great hope that the problem can be solved in higher proportion of patients. The aim of the study reported here is to further test the ability of MRI in this setting.