Format

Send to

Choose Destination
Spine (Phila Pa 1976). 2018 Nov 20. doi: 10.1097/BRS.0000000000002947. [Epub ahead of print]

The Association Between Pre-operative MRI Findings and Surgical Revision Within Three Years After Surgery for Lumbar Disc Herniation.

Author information

1
Spine Surgery and Research, Spine Center of Southern Denmark - part of Lillebaelt Hospital.
2
Institute of Regional Health Research, University of Southern Denmark.
3
Nordic Institute of Chiropractic and Clinical Biomechanics, Denmark.

Abstract

STUDY DESIGN:

This cohort study was an analysis of prospectively collected data in the DaneSpine Database.

OBJECTIVE:

The objective was to determine whether pre-operative magnetic resonance imaging (MRI) findings were associated with the frequency of surgical revision due to recurrent lumbar disc herniation (LDH) within three years after first-time, single-level, simple lumbar discectomy.

SUMMARY OF BACKGROUND DATA:

Because of a risk of poorer outcome in patients receiving revision surgery compared to first-time discectomy, there is a need to identify patients with LDH in risk of surgical revision prior to the primary discectomy. The association between pre-operative MRI findings and revision surgery in patients with LDH has not been thoroughly studied.

METHODS:

Following an inter-observer reliability study pre-operative MRIs were evaluated. Potential predictive variables for surgical revision were evaluated using univariate and multivariate logistic regression analysis. Also, a sum-score of the number of MRI findings at the involved level was assessed.

RESULTS:

In a study population of 451 operated patients, those who had surgical revision were significantly younger and were significantly less likely to have vertebral endplate signal changes Type 2 (OR 0.36 (95% CI 0.15-0.88)) or more than five MRI findings (OR 0.45 (95% CI 0.21-0.95)) at the involved level than the patients not undergoing surgical revision. Surgical revision was not significantly associated with any other MRI findings.

CONCLUSIONS:

In general, pre-operative MRI findings have a limited explanatory value in predicting surgical revision within three years after first time, single-level, simple lumbar discectomy. Both the single variable VESC Type 2 and a sum-score > 5 MRI findings at the operated level was found to be negatively associated with patients undergoing surgical revision.

LEVEL OF EVIDENCE:

3.

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center