|
KMID : 1146020120050020023
|
|
Journal of Critical Spine Cases
2012 Volume.5 No. 2 p.23 ~ p.28
|
|
|
Early Revision Surgery due to Incomplete Decompression after Lumbar Microdiscectomy: Postoperative MRI Findings
|
|
Kim Jin-Sung
|
|
|
Abstract
|
|
|
Purpose: The purpose of this study was to evaluate the radiological findings on early postoperative magnetic resonance imaging predictive of the need for revision surgery after lumbar microdiscectomy.
Methods: The study used data from 2523 consecutive patients treated with open lumbar microdiscectomy due to disc herniation. All patients underwent magnetic resonance imaging before and on the next day after the surgery. The residual disc volume and the grade of nerve root compromise were evaluated. Among them, 15 patients (0.6%) had revision surgery within one week because of incomplete decompression. The revision group was compared with a control group composed of 35 agematched, randomly selected patients with no evidence of residual radiculopathy. The herniated disc volume and the grade of nerve root compromise were measured on pre- and postoperative magnetic resonance imaging scans.
Results: Of the 15 revision cases, 7 operations were performed at L4-5; 6, at L5-S1; 1, at L3-4; and 1, at L2-3. The mean time until the subsequent operation was 3 days (range: 1-5 days). The demographics and residual disc volume were not different between the revision group and the control group. The postoperative grade of nerve root compromise was significantly higher in revision group. The mean grade of nerve root compromise in the revision group was 1.93±0.70, whereas that in the control group was 0.51±0.61 (p<0.0001).
Conclusion: According to our results, the degree of nerve root compromise is more useful than the amount of residual disc in predicting the need for future revision surgery after lumbar microdiscectomy.
|
|
|
KEYWORD
|
|
|
Lumbar discectomy, Nerve root compression, Postoperative MRI, Residual disc, Revision surgery
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|