| 1. |
- Albeck, Michael J, et al.
(författare)
-
A controlled comparison of myelography, computed tomography, and magnetic resonance imaging in clinically suspected lumbar disc herniation
- 1995
-
Ingår i: Spine. - 0362-2436. ; 20:4, s. 443-448
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN. A controlled prospective blinded study. OBJECTIVES. To compare the diagnostic power of myelography, computed tomography and magnetic resonance imaging in the diagnosis of low lumbar disc herniation. METHODS. Eighty patients with monoradicular sciatica were examined by myelography, computed tomography, and magnetic resonance imaging, and all underwent subsequent surgery. The images were evaluated twice in a blinded fashion, and the diagnostic power of the modalities was expressed by a decision-analytic regret function. RESULTS. In 57 patients (71%) a disc herniation at the expected level was disclosed at surgery. The largest amount of diagnostic information was gained from computed tomography, followed by magnetic resonance imaging and myelography. Both computed tomography and magnetic resonance imaging were significantly informative, whereas this was not the case for myelography. CONCLUSION. The results indicate that computed tomography or magnetic resonance imaging should be the first choice for imaging in patients with suspected lumbar disc herniation.
|
|
| 2. |
- Annertz, Mårten, et al.
(författare)
-
No relationship between epidural fibrosis and sciatica in the lumbar postdiscectomy syndrome. A study with contrast-enhanced magnetic resonance imaging in symptomatic and asymptomatic patients
- 1995
-
Ingår i: Spine. - 0362-2436. ; 20:4, s. 449-453
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN. Symptomatic patients were retrospectively analyzed and compared with a control group from an ongoing prospective and consecutive study. OBJECTIVES. To determine the presence and extent of epidural fibrosis in patients with and without recurrent sciatic pain after previous lumbar discectomy, contrast-enhanced magnetic resonance images were evaluated and correlated with surgical findings in the symptomatic patients. Recurrent hernia and bony stenosis were ruled out as the probable causative agent, as well as any morphologic explanation other than fibrosis. SUMMARY OF BACKGROUND DATA. Repeat surgical results for patients with the lumbar postdiscectomy syndrome with epidural fibrosis alone are often unfavorable. The pathogenic role of epidural fibrosis, however, has not been established. METHODS. The magnetic resonance images of eight patients with recurrent or persistent sciatic pain after lumbar discectomy were compared with those of eight asymptomatic patients constituting a control group. All were examined with magnetic resonance imaging on a 0.3 T unit before and after intravenous injection of gadolinium-DTPA, and clinically, 6 months to 4 years after surgery. The symptomatic patients subsequently underwent reoperation. RESULTS. Fourteen patients had focal or diffuse epidural fibrosis around the nerve root and/or the thecal sac at the operated level, whereas the postoperative findings for two patients were "normal," one in the operated and one in the control group. No difference between the groups regarding mass effect or affection of the nerve roots or thecal sac was noted. At reoperation of the eight symptomatic patients, fibrosis was the only pathologic finding in all cases except one, in which surgery confirmed the normal finding on magnetic resonance imaging. Six of the eight operated patients had recurrent or persistent symptoms within a year of the reoperation. CONCLUSION. No differences regarding the presence and extent of epidural fibrosis between the symptomatic and asymptomatic patients could be demonstrated with contrast-enhanced magnetic resonance imaging. The role of epidural fibrosis as the causative agent in the lumbar postdiscectomy syndrome is questioned.
|
|
| 3. |
|
|
