Intravenous contrast-enhanced CT of the postoperative lumbar spine: improved identification of recurrent disk herniation, scar, arachnoiditis, and diskitis
Unsuccessful relief of symptoms after back surgery is usually attributable to hypertrophic extradural scar or recurrent herniated disk. Their clinical and myelographic differentiation is difficult, yet important because reoperation is not always beneficial for scar removal. This article examines the...
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| Veröffentlicht in: | AJR, Am. J. Roentgenol.; (United States) Am. J. Roentgenol.; (United States), 1984-10, Vol.143 (4), p.845-855 |
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| container_title | AJR, Am. J. Roentgenol.; (United States) |
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| creator | Teplick, JG Haskin, ME |
| description | Unsuccessful relief of symptoms after back surgery is usually attributable to hypertrophic extradural scar or recurrent herniated disk. Their clinical and myelographic differentiation is difficult, yet important because reoperation is not always beneficial for scar removal. This article examines the usefulness of intravenous contrast-enhanced computed tomography for this problem. Forty-five postsurgical patients were studied; eight had subsequent surgery. In the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with recurrent disk herniation, nonenhancement of the extruded disk allowed its recognition in three. In the other 37 patients who were not reoperated, 33 were believed to have scar on the basis of contrast enhancement. Continuous contrast infusion during scanning, absolute avoidance of patient movement, and careful consideration of other structures in the spinal canal are important in interpretation. The method seems promising for more accurate evaluation of failed back surgery, including the recognition of diskitis. |
| doi_str_mv | 10.2214/ajr.143.4.845 |
| format | Article |
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Continuous contrast infusion during scanning, absolute avoidance of patient movement, and careful consideration of other structures in the spinal canal are important in interpretation. 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In the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with recurrent disk herniation, nonenhancement of the extruded disk allowed its recognition in three. In the other 37 patients who were not reoperated, 33 were believed to have scar on the basis of contrast enhancement. Continuous contrast infusion during scanning, absolute avoidance of patient movement, and careful consideration of other structures in the spinal canal are important in interpretation. The method seems promising for more accurate evaluation of failed back surgery, including the recognition of diskitis.</description><subject>550602 - Medicine- External Radiation in Diagnostics- (1980-)</subject><subject>Arachnoiditis - diagnostic imaging</subject><subject>BODY</subject><subject>Cicatrix - diagnostic imaging</subject><subject>COMPUTERIZED TOMOGRAPHY</subject><subject>CONTRAST MEDIA</subject><subject>DIAGNOSIS</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DISEASES</subject><subject>Humans</subject><subject>Infusions, Parenteral</subject><subject>Intervertebral Disc - diagnostic imaging</subject><subject>Intervertebral Disc Displacement - diagnostic imaging</subject><subject>Lumbosacral Region</subject><subject>MEDICINE</subject><subject>ORGANS</subject><subject>PATIENTS</subject><subject>Postoperative Period</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Recurrence</subject><subject>SKELETAL DISEASES</subject><subject>SKELETON</subject><subject>Spinal Diseases - diagnostic imaging</subject><subject>SURGERY</subject><subject>TOMOGRAPHY</subject><subject>Tomography, X-Ray Computed</subject><subject>VERTEBRAE</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkUFv3CAUhFHVKt2kPfZYCfXQU7wBg222t2qVtJEi5ZJKvaG38FyT2tgFvKv-lv7Z4OyquYAGPgbNG0I-cLYuSy6v4DGsuRRruVayekVWvJJ1Ibjkr8mKiZoXiomfb8l5jI-MsUZtmjNyVgtRyk29Iv9ufQqwRz_OkZpxETEV6DvwBi3dPtCxpalDOo0xjRMGSG6PtJ-HHQQaJ-fxC3XDFMZ9xp1Fn1zrTKZGvzwNaOYQ8im1Lv6mHQbvni8vaTQQLikEMJ0fnXXJxSy9fSYX9Y68aaGP-P60X5AfN9cP2-_F3f232-3Xu8IIVaWcr5Q5L1jOQSqJogVWMeB2J6FqLAqo1E6VDWugMWBbMBI2wBXjpsprJS7Ip6Nvjuh0NC6h6fIsPJqk6wyUmwX6fIRy1D8zxqQHFw32PXjMs9OKl1KqqslgcQRNGGMM2OopuAHCX82ZXhrTuTGdG9NS58Yy__FkPO8GtP_pU0UvH3fuV3dwAXUcoO8zzfXhcHgxegLscqJV</recordid><startdate>198410</startdate><enddate>198410</enddate><creator>Teplick, JG</creator><creator>Haskin, ME</creator><general>Am Roentgen Ray Soc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>198410</creationdate><title>Intravenous contrast-enhanced CT of the postoperative lumbar spine: improved identification of recurrent disk herniation, scar, arachnoiditis, and diskitis</title><author>Teplick, JG ; Haskin, ME</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c385t-8024314ad11a484e3fa050a1db4a57de3a58b82707a7cadfac4a9a1801c518053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>550602 - Medicine- External Radiation in Diagnostics- (1980-)</topic><topic>Arachnoiditis - diagnostic imaging</topic><topic>BODY</topic><topic>Cicatrix - diagnostic imaging</topic><topic>COMPUTERIZED TOMOGRAPHY</topic><topic>CONTRAST MEDIA</topic><topic>DIAGNOSIS</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DISEASES</topic><topic>Humans</topic><topic>Infusions, Parenteral</topic><topic>Intervertebral Disc - diagnostic imaging</topic><topic>Intervertebral Disc Displacement - diagnostic imaging</topic><topic>Lumbosacral Region</topic><topic>MEDICINE</topic><topic>ORGANS</topic><topic>PATIENTS</topic><topic>Postoperative Period</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Recurrence</topic><topic>SKELETAL DISEASES</topic><topic>SKELETON</topic><topic>Spinal Diseases - diagnostic imaging</topic><topic>SURGERY</topic><topic>TOMOGRAPHY</topic><topic>Tomography, X-Ray Computed</topic><topic>VERTEBRAE</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teplick, JG</creatorcontrib><creatorcontrib>Haskin, ME</creatorcontrib><creatorcontrib>Hahnemann Univ. 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Roentgenol.; (United States)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>1984-10</date><risdate>1984</risdate><volume>143</volume><issue>4</issue><spage>845</spage><epage>855</epage><pages>845-855</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><abstract>Unsuccessful relief of symptoms after back surgery is usually attributable to hypertrophic extradural scar or recurrent herniated disk. Their clinical and myelographic differentiation is difficult, yet important because reoperation is not always beneficial for scar removal. This article examines the usefulness of intravenous contrast-enhanced computed tomography for this problem. Forty-five postsurgical patients were studied; eight had subsequent surgery. In the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with recurrent disk herniation, nonenhancement of the extruded disk allowed its recognition in three. In the other 37 patients who were not reoperated, 33 were believed to have scar on the basis of contrast enhancement. Continuous contrast infusion during scanning, absolute avoidance of patient movement, and careful consideration of other structures in the spinal canal are important in interpretation. The method seems promising for more accurate evaluation of failed back surgery, including the recognition of diskitis.</abstract><cop>United States</cop><pub>Am Roentgen Ray Soc</pub><pmid>6332496</pmid><doi>10.2214/ajr.143.4.845</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0361-803X |
| ispartof | AJR, Am. J. Roentgenol.; (United States), 1984-10, Vol.143 (4), p.845-855 |
| issn | 0361-803X 1546-3141 |
| language | eng |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | 550602 - Medicine- External Radiation in Diagnostics- (1980-) Arachnoiditis - diagnostic imaging BODY Cicatrix - diagnostic imaging COMPUTERIZED TOMOGRAPHY CONTRAST MEDIA DIAGNOSIS DIAGNOSTIC TECHNIQUES DISEASES Humans Infusions, Parenteral Intervertebral Disc - diagnostic imaging Intervertebral Disc Displacement - diagnostic imaging Lumbosacral Region MEDICINE ORGANS PATIENTS Postoperative Period RADIOLOGY AND NUCLEAR MEDICINE Recurrence SKELETAL DISEASES SKELETON Spinal Diseases - diagnostic imaging SURGERY TOMOGRAPHY Tomography, X-Ray Computed VERTEBRAE |
| title | Intravenous contrast-enhanced CT of the postoperative lumbar spine: improved identification of recurrent disk herniation, scar, arachnoiditis, and diskitis |
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