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American Journal of Neuroradiology, Vol 19, Issue 1 183-186, Copyright © 1998 by American Society of Neuroradiology


ARTICLES

The postoperative lumbar spine: evaluation of epidural scar over a 1- year period

JS Ross, N Obuchowski and R Zepp
Division of Radiology, Cleveland Clinic Foundation, OH 44195, USA.

PURPOSE: We documented the morphological changes on enhanced MR imaging studies that occur in epidural scar over a period of 1 year after lumbar diskectomy. METHODS: The study population was culled from a randomized, multicenter clinical trial designed to evaluate the efficacy of a device inhibiting postoperative epidural fibrosis after single-level, unilateral laminectomy/diskectomy for herniated lumbar disk. Analysis was restricted to 71 control subjects who did not receive the device. All patients underwent surgery after receiving clinical and MR examinations, with follow-up MR studies at 6 and 12 months. Evaluation of all MR images was performed by one interpreter, who was blinded to treatment arm and clinical findings. The extent of epidural scar seen at the 6- and 12-month MR examinations was graded on a scale of 0 to 4 for each quadrant at each imaging section encompassing the surgical level. RESULTS: Eighty-five percent of the patients had no change in the amount of anterior epidural scar between the 6- and 12-month MR examinations; 75% of the patients showed no change in the amount of posterior epidural scar between the 6- and 12- month examinations. CONCLUSION: The majority of our patients had no change in the amount of epidural scarring visible at enhanced MR imaging over a 1-year period after lumbar laminectomy/diskectomy.


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