Early postoperative MRI findings following anterior cervical discectomy and fusion: What to expect when the unexpected happens.
Acute
Anterior cervical discectomy and fusion
Compression
Magnetic resonance imaging
Mass effect
Postoperative
Signal intensity
Journal
World neurosurgery: X
ISSN: 2590-1397
Titre abrégé: World Neurosurg X
Pays: United States
ID NLM: 101747743
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
17
11
2022
revised:
14
02
2023
accepted:
16
03
2023
medline:
8
4
2023
entrez:
7
4
2023
pubmed:
8
4
2023
Statut:
epublish
Résumé
Magnetic resonance imaging (MRI) is not routinely ordered following spinal fusion. Some literature suggests MRIs are unhelpful due to postoperative changes that obscure interpretation. We aim to describe findings of acute postoperative MRI following anterior cervical discectomy and fusion (ACDF). The authors retrospectively analyzed adult MRIs completed within 30 days of ACDF (from 2005-2022). T1 and T2 signal intensity in the interbody space dorsal to the graft, mass effect on the dura/spinal cord, intrinsic spinal cord T2 signal, and interpretability were reviewed. In 38 patients there were 58 ACDF levels (1, 2, and 3 levels; 23, 10, and 5, respectively). MRIs were completed on mean postoperative day 8.37 (range; 0-30 days). T1-weighted imaging was described as isointense, hyperintense, heterogenous, and hypointense in 48 (82.8%), 5 (8.6%), 3 (5.2%), and 2 levels (3.4%), respectively. T2-weighted imaging was described as hyperintense, heterogenous, isointense, and hypointense in 41 (70.7%), 12 (20.7%), 3 (5.2%), and 2 levels (3.4%), respectively. There was no mass effect in 27 levels (46.6%), 14 (24.1%) had thecal sac compression, and 17 (29.3%) had cord compression. The majority of MRIs exhibited readily compression and intrinsic spinal cord signal even with various types of fusion constructs. Early MRI after lumbar surgery can be difficult to interpret. However, our results support the use of early MRI to investigate neurological complaints following ACDF. Our findings do not support the idea that epidural blood products and mass effect on the cord are seen in most postoperative MRIs after ACDF.
Sections du résumé
Background
UNASSIGNED
Magnetic resonance imaging (MRI) is not routinely ordered following spinal fusion. Some literature suggests MRIs are unhelpful due to postoperative changes that obscure interpretation. We aim to describe findings of acute postoperative MRI following anterior cervical discectomy and fusion (ACDF).
Methods
UNASSIGNED
The authors retrospectively analyzed adult MRIs completed within 30 days of ACDF (from 2005-2022). T1 and T2 signal intensity in the interbody space dorsal to the graft, mass effect on the dura/spinal cord, intrinsic spinal cord T2 signal, and interpretability were reviewed.
Results
UNASSIGNED
In 38 patients there were 58 ACDF levels (1, 2, and 3 levels; 23, 10, and 5, respectively). MRIs were completed on mean postoperative day 8.37 (range; 0-30 days). T1-weighted imaging was described as isointense, hyperintense, heterogenous, and hypointense in 48 (82.8%), 5 (8.6%), 3 (5.2%), and 2 levels (3.4%), respectively. T2-weighted imaging was described as hyperintense, heterogenous, isointense, and hypointense in 41 (70.7%), 12 (20.7%), 3 (5.2%), and 2 levels (3.4%), respectively. There was no mass effect in 27 levels (46.6%), 14 (24.1%) had thecal sac compression, and 17 (29.3%) had cord compression.
Conclusions
UNASSIGNED
The majority of MRIs exhibited readily compression and intrinsic spinal cord signal even with various types of fusion constructs. Early MRI after lumbar surgery can be difficult to interpret. However, our results support the use of early MRI to investigate neurological complaints following ACDF. Our findings do not support the idea that epidural blood products and mass effect on the cord are seen in most postoperative MRIs after ACDF.
Identifiants
pubmed: 37026085
doi: 10.1016/j.wnsx.2023.100188
pii: S2590-1397(23)00037-6
pmc: PMC10070176
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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