20. A Prospective Cohort Study of Close Interval CT And MRi Imaging after Primary Lumbar Discectomy: Factors Associated with Recurrent Disc Herniation and Disc Height Loss

McGirt, Matthew J.; Eustacchio, Sandro; Varga, Péter Pál; Velendecic, Milorad; Eškinja, Neven; Trummer, M.; Gorenšek, Matevž; Ledić, Darko; Gokaslan, Ziya L.; Carragee, Eugene J.

doi:10.1016/j.spinee.2009.08.026

Cited by 16 publications

(25 citation statements)

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“…We recently reported the results of a prospective, controlled, multi-institutional cohort study with standardized sequential imaging for 2 years after lumbar discectomy. 7 This study demonstrated a 10% incidence of symptomatic same-site recurrent disc herniation requiring reoperation. However, the incidence and clinical signifi cance of asymptomatic radiographic recurrent herniation was not analyzed.…”

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confidence: 62%

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Asymptomatic Same-Site Recurrent Disc Herniation After Lumbar Discectomy

Lebow

Adogwa

Parker

et al. 2011

Spine

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Nearly one-fourth of patients undergoing lumbar discectomy demonstrated radiographic evidence of recurrent disc herniation at the level of prior surgery, the majority of which were asymptomatic. Asymptomatic disc herniation was not associated with clinical consequences by 2 years. Clinically silent recurrent disc herniation is common after lumbar discectomy. When obtaining MRI evaluation within the first 2 years of discectomy, providers should expect that radiographic evidence of reherniation may be encountered and that treatment should be considered only when correlating radicular symptoms exist.

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confidence: 62%

“…To calculate average disc height, three-dimensional CT modeling was utilized to measure the disc height at six standardized points within the intravertebral disc space as previously described. 7 This technique has been demonstrated to be accurate within 0.5% when compared to cadaveric measurements. 9…”

Section: Radiographic Measuresmentioning

confidence: 89%

Asymptomatic Same-Site Recurrent Disc Herniation After Lumbar Discectomy

Lebow

Adogwa

Parker

et al. 2011

Spine

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“…Barth et al reported a significant increase in endplate degeneration and disc dehydration following discectomies (3). A standard open discectomy involving incising the annulus and removal of the nucleus pulposus increased disc degeneration, and the loss of height of the operative disc space also frequently occurs after the surgery (23), as demonstrated in our technique.…”

Section: █ Discussionmentioning

confidence: 58%

Initial discectomy associated with aging lead to adjacent disc disease and recurrence

Dalgıç

Yıldırım²,

Okay³

et al. 2015

Turkish Neurosurgery

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difficulties, especially the persistence and recurrence of symptoms. Failure of surgical treatment for LDH can be caused by the true recurrence of disc herniation, new disc herniation at a different disc level, epidural fibrosis, arachnoiditis, foraminal stenosis, and segmental instability (8, 21-23, 29, 30, 32). The overall rate of unsatisfactory discectomy results range from 5% to 20% of recurrent disc herniation and it is the major █ INTRODUCTIONLumbar discectomy is the most common surgical procedure performed by spine surgeons for patients complaining of back and leg pain. Numerous new techniques have been used to improve the efficacy of the surgical excision of herniated intervertebral discs but these procedures still include some AIM: Failure of surgery for lumbar disc herniation (LDH) can be commonly caused by recurrence. There are many debates regarding the risk factors of recurrent LDH (rLDH) and it is very difficult to define them because many clinical and complicated biomechanical parameters are involved. The purpose of study was to evaluate the long term result of re-discectomy for LDH at the same level and adjacent segments. MATERIAL and METHODS:Between 1999 and 2009, 1898 cases were operated and 142 (6.4%) patients underwent re-discectomy following initial operation. The study included 65 patients who were operated for single level discectomy, and their charts were analyzed retrospectively. RESULTS:There were 33 (50.8%) women and mean age was 45.5 years (24-73 years). rLDH was diagnosed at the initial level in 40 (61.5%) but adjacent and/or opposite level herniation (with or without the first level) was found in the remaining 25 cases (39.1%). Recurrence at the same level (SLG) and adjacent level groups (ALG) were similar according to the clinical outcomes in follow-up (mean 34.1 months). Admission period after initial operation was also parallel in SLG and ALG (54.7 and 53.1 months, respectively). However, the mean age of ALG (49.4 years) was significantly higher (p≤0.05) than SLG (42.8 years). CONCLUSION:After discectomy, collapsed discs are biomechanically more stable than those with preserved disc heights, and responses to axial compression on intervertebral disc pressure produced deformations of adjacent levels despite limitations.Altered biomechanical loading next to a fusion resulted in ongoing degeneration with aging at the affected entire lumbar spine.

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“…[3][4][5] Disk height measurements are used to optimize the fit of implants and prostheses 6,7 and to assess the outcome of surgical interventions. 8,9 Similarly, vertebral height has been used to assess the effectiveness of height restoration procedures. 10,11 Vertebral height measurement is also important in assessment of vertebral fractures.…”

Section: Introductionmentioning

confidence: 99%

“…6,7,9,10,13 CT and MRI provide complete 3D information about anatomical structures. CT can achieve higher resolution and is better suited to bone visualization.…”

Section: Introductionmentioning

confidence: 99%

High precision semiautomated computed tomography measurement of lumbar disk and vertebral heights

Tan

Yao

et al. 2012

Medical Physics

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Purpose: Evaluation of treatments of many spine disorders requires precise measurement of the heights of vertebral bodies and disk spaces. The authors present a semiautomated computer algorithm measuring those heights from spine computed tomography (CT) scans and evaluate its precision. Methods: Eight patients underwent two spine CT scans in the same day. In each scan, five thoracolumbar vertebral heights and four disk heights were estimated using the algorithm. To assess precision, the authors computed the differences between the height measurements in the two scans, coefficients of variation (CV), and 95% limits of agreement. Intraoperator and interoperator precisions were evaluated. For local vertebral and disk height measurement (anterior, middle, posterior) the algorithm was compared to a manual mid-sagittal plane method. Results: The mean (standard deviation) interscan difference was as low as 0.043 (0.031) mm for disk heights and 0.044 (0.043) mm for vertebral heights. The corresponding 95% limits of agreement were [−0.085, 0.11] and [−0.10, 0.12] mm, respectively. Intraoperator and interoperator precision was high, with a maximal CV of 0.30%. For local vertebral and disk heights, the algorithm improved upon the precision of the manual mid-sagittal plane measurement by as much as a factor of 6 and 4, respectively. Conclusions:The authors evaluated the precision of a novel computer algorithm for measuring vertebral body heights and disk heights using short term repeat CT scans of patients. The 95% limits of agreement indicate that the algorithm can detect small height changes of the order of 0.1 mm.

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20. A Prospective Cohort Study of Close Interval CT And MRi Imaging after Primary Lumbar Discectomy: Factors Associated with Recurrent Disc Herniation and Disc Height Loss

Cited by 16 publications

References 0 publications

Asymptomatic Same-Site Recurrent Disc Herniation After Lumbar Discectomy

Asymptomatic Same-Site Recurrent Disc Herniation After Lumbar Discectomy

Initial discectomy associated with aging lead to adjacent disc disease and recurrence

High precision semiautomated computed tomography measurement of lumbar disk and vertebral heights

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