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Imaging of the Postoperative Spine

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The Disc and Degenerative Disc Disease

Part of the book series: New Procedures in Spinal Interventional Neuroradiology ((NPSIN))

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Abstract

Imaging of the postoperative spine is common in everyday practice. Adequate interpretation requires detailed knowledge of the surgical procedure and clinical presentation, and good quality diagnostic imaging requires judicial imaging techniques and parameters. In this chapter, we will review different types of surgical techniques and imaging modalities commonly used. We will describe the imaging findings in early and delayed complications of failed back surgery syndrome. At the end of the chapter, we will present a problem-solving approach to common challenges in interpretation of certain clinical and radiologic conditions.

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References

  1. Merskey H, Bogduk N. Lumbar spinal or radicular pain after failed spinal surgery. Classification of chronic pain IASP second edition. Washington, DC: ISAP; 1994.

    Google Scholar 

  2. Thomson S. Failed back surgery syndrome – definition, epidemiology and demographics. Br J Pain. 2013;7(1):56–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tronnier VM, Eldabe S, Franke J, Huygen F, Rigoard P, de Andres AJ, Assaker R, Gomez-Rice A, La Grua M, Moens M, Moke L, Perruchoud C, Quraishi NA, Rothenfluh DA, Tabatabaei P, Van Boxem K, Vleggeert-Lankamp C, Zoëga B, Stoevelaar HJ. The appropriate management of persisting pain after spine surgery: a European panel study with recommendations based on the RAND/UCLA method. Eur Spine J. 2019;28(1):31–45.

    Article  PubMed  Google Scholar 

  4. Herrera Herrera I, Moreno de la Presa R, González Gutiérrez R, Bárcena Ruiz E, García Benassi JM. Evaluation of the postoperative lumbar spine. Radiologia. 2013;55(1):12–23.

    Article  CAS  PubMed  Google Scholar 

  5. Gupta A, Subhas N, Primak AN, Nittka M, Liu K. Metal artifact reduction standard and advanced magnetic resonance and computed tomography techniques. Radiol Clin N Am. 2015;53:531–47.

    Article  PubMed  Google Scholar 

  6. Grand CM, Bank WO, Balériaux D, Matos C, Levivier M, Brotchi J. Gadolinium enhancement of vertebral endplates following lumbar disc surgery. Neuroradiology. 1993;35:503–5.

    Article  CAS  PubMed  Google Scholar 

  7. Van Goethem JW, Van de Kelft E, Biltjes IGGM, van Hasselt BA, van den Hauwel PPM, et al. MRI after successful lumbar discectomy. Neuroradiology. 1996;38(Suppl. 1):S90–6.

    Article  PubMed  Google Scholar 

  8. Venu V, Vertinsky AT, Malfair D, et al. Plain radiograph assessment of spinal hardware. Semin Musculoskelet Radiol. 2011;15:151–62.

    Article  PubMed  Google Scholar 

  9. Rutherford EE, Tarplett LJ, Davies EM, et al. Lumbar spine fusion and stabilization: hardware, techniques, and imaging appearances. Radiographics. 2007;27:1737–49.

    Article  PubMed  Google Scholar 

  10. Young PM, Berquist TH, Bancroft LW, et al. Complications of spinal instrumentation. Radiographics. 2007;27:775–89.

    Article  PubMed  Google Scholar 

  11. Malhotra A, Kalra VB, Wu X, Grant R, Bronen RA, Abbed KM. Imaging of lumbar spinal surgery complications. Insights Imaging. 2015 Dec;6(6):579–90.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gercek E, Arlet V, Delisle J, et al. Subsidence of stand-alone cervical cages in anterior interbody fusion: warning. Eur Spine J. 2003;12:513–6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sethi A, Craig J, Bartol S, ChenW JM, Coe C, et al. Radiographic and CT evaluation of recombinant human bone morphogenetic protein-2-assisted spinal interbody fusion. AJR Am J Roentgenol. 2011;197(1):W128–33.

    Article  PubMed  Google Scholar 

  14. Suk KS, Lee HM, Moon SH, Kim NH. Recurrent lumbar disc herniation: results of operative management. Spine (Phila Pa 1976). 2001;26:672–6.

    Article  CAS  Google Scholar 

  15. Georgy BA, Hesselink JR, Middleton MS. Fat-suppression contrast-enhanced MRI in the failed back surgery syndrome: a prospective study. Neuroradiology. 1995;37:51–7.

    Article  CAS  PubMed  Google Scholar 

  16. Vogelsang JP, Finkenstaedt M, Vogelsang M, Markakis E. Recurrent pain after lumbar discectomy: the diagnostic value of peridural scar on MRI. Eur Spine J. 1999;8:457–9.

    Article  Google Scholar 

  17. Ross JS, Robertson JT, Frederickson RC, Petrie JL, Obuchowski N, Modic MT, et al. Association between peridural scar and recurrent radicular pain after lumbar discectomy: magnetic resonance evaluation. ADCON-L European Study Group. Neurosurgery. 1996;38:855–61.

    Article  CAS  PubMed  Google Scholar 

  18. Fitt GJ, Stevens JM. Postoperative arachnoiditis diagnosed by high resolution fast spin-echo MRI of the lumbar spine. Neuroradiology. 1995;37:139–45.

    Article  CAS  PubMed  Google Scholar 

  19. Ross JS, Masaryk TJ, Modic MT, Delamater R, Bohlman H, Wilbur G, et al. MR imaging of lumbar arachnoiditis. Am J Roentgenol. 1987;149:1025–32.

    Article  CAS  Google Scholar 

  20. Jinkins JR. Magnetic resonance imaging of benign nerve root enhancement in the unoperated and postoperative lumbosacral spine. Neuroimag Clin N Am. 1993;3:525–41.

    Google Scholar 

  21. Jinkins JR, Roeder MB. MRI of benign lumbosacral nerve root enhancement. Semin Ultrasound CT MR. 1993;14:446–54.

    Article  CAS  PubMed  Google Scholar 

  22. Lee CS, Hwang CJ, Lee SW, et al. Risk factors for adjacent segment disease after lumbar fusion. Eur Spine J. 2009;18:1637–43.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cho KJ, Suk SI, Park SR, et al. Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine (Phila Pa 1976). 2007;32:2232–7.

    Article  Google Scholar 

  24. Berquist TH. Imaging of the postoperative spine. Radiol Clin N Am. 2006;44:407–18.

    Article  PubMed  Google Scholar 

  25. Willson MC, Ross JS. Postoperative spine complications. Neuroimaging Clin N Am. 2014;24(2):305–26.

    Article  PubMed  Google Scholar 

  26. Hong SH, Choi JY, Lee JW, et al. MR imaging assessment of the spine: infection or an imitation? Radiographics. 2009;29(2):599–612.

    Article  CAS  PubMed  Google Scholar 

  27. Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010;65(Suppl 3):iii11–24.

    CAS  PubMed  Google Scholar 

  28. Eguchi Y, Ohtori S, Yamashita M, Yamauchi K, Suzuki M, Orita S, Kamoda H, Arai G, Ishikawa T, Miyagi M, Ochiai N, Kishida S, Masuda Y, Ochi S, Kikawa T, Takaso M, Aoki Y, Inoue G, Toyone T, Takahashi K. Diffusion magnetic resonance imaging to differentiate degenerative from infectious endplate abnormalities in the lumbar spine. Spine (Phila Pa 1976). 2011 Feb 1;36(3):E198–202.

    Article  Google Scholar 

  29. Fuster D, Tomás X, Mayoral M, Soriano A, Manchón F, Cardenal C, Monegal A, Granados U, Garcia S, Pons F. Prospective comparison of whole-body (18)F-FDG PET/CT and MRI of the spine in the diagnosis of haematogenous spondylodiscitis. Eur J Nucl Med Mol Imaging. 2015 Feb;42(2):264–71.

    Article  CAS  PubMed  Google Scholar 

  30. Jain NK, Dao K, Ortiz AO. Radiologic evaluation and management of postoperative spine paraspinal fluid collections. Neuroimaging Clin N Am. 2014 May;24(2):375–89.

    Article  PubMed  Google Scholar 

  31. Moritani T, Kim J, Capizzano AA, Kirby P, Kademian J, Sato Y. Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections. Br J Radiol. 2014;87(1041):20140011.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Floris R, Spallone A, Aref TY, Rizzo A, Apruzzese A, Mulas M, Castriota Scanderbeg A, Simonetti G. Early postoperative MRI findings following surgery for herniated lumbar disc. Part II: a gadolinium-enhanced study. Acta Neurochir. 1997;139(12):1101–7.

    Article  CAS  PubMed  Google Scholar 

  33. Hueftle MG, Modic MT, Ross JS, Masaryk TJ, Carter JR, Wilber RG, Bohlman HH, Steinberg PM, Delamarter RB. Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology. 1988 Jun;167(3):817–24.

    Article  CAS  PubMed  Google Scholar 

  34. Nasser R, Yadla S, Maltenfort MG, Harrop JS, Anderson DG, Vaccaro AR, Sharan AD, Ratliff JK. Complications in spine surgery. J Neurosurg Spine. 2010 Aug;13(2):144–57.

    Article  PubMed  Google Scholar 

  35. Sethi A, Craig J, Bartol S, Chen W, Jacobson M, Coe C, Vaidya R. Radiographic and CT evaluation of recombinant human bone morphogenetic protein-2-assisted spinal interbody fusion. AJR Am J Roentgenol. 2011;197(1):W128–33. https://doi.org/10.2214/AJR.10.5484. Erratum in: AJR Am J Roentgenol. 2011;197(4):1024.

    Article  PubMed  Google Scholar 

  36. Zampolin R, Erdfarb A, Miller T. Imaging of lumbar spine fusion. Neuroimaging Clin N Am. 2014;24(2):269–86.

    Article  PubMed  Google Scholar 

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Correspondence to Bassem A. Georgy .

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Georgy, M.M., Georgy, B.A. (2020). Imaging of the Postoperative Spine. In: Manfrè, L., Van Goethem, J. (eds) The Disc and Degenerative Disc Disease. New Procedures in Spinal Interventional Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-030-03715-4_6

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  • DOI: https://doi.org/10.1007/978-3-030-03715-4_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-03714-7

  • Online ISBN: 978-3-030-03715-4

  • eBook Packages: MedicineMedicine (R0)

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