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Abstract

Spinal nerve enhancement with Gd-DTPA: MR correlation with the postoperative lumbosacral spine.

J R Jinkins, A G Osborn, D Garrett, S Hunt and J L Story
American Journal of Neuroradiology March 1993, 14 (2) 383-394;
J R Jinkins
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
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A G Osborn
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
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D Garrett Jr
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
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S Hunt
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
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J L Story
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
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Abstract

PURPOSE To search for a probable source of the recurrent signs and symptoms associated with lumbosacral postsurgical syndrome on intravenous gadolinium-enhanced MR.

METHODS A retrospective study of 120 patients with recurrent symptomatology following lumbar disk surgery was carried out with spin-echo MR pre- and postenhancement with gadopentetate dimeglumine (0.1 mmol/kg). In addition, 10 asymptomatic subjects were evaluated at least 6 months postoperatively using the same imaging protocol.

RESULTS 21.6% of the symptomatic subjects (N = 26) had enhancement of one or more spinal nerve root. This enhancement was focal or multisegmental, and involved single or multiple nerve roots. The abnormal neural enhancement was associated with otherwise isolated epidural fibrosis in 88.5%, and with herniated nucleus pulposus in the remaining 11.5%. The overall clinical correlation of single root enhancement with a monoradiculopathy and multiroot enhancement with a polyradiculopathy was 95.7%. However, 21.7% of these same cases also showed additional nerve root enhancement that did not have an overt clinical correlation. All of these latter patients were imaged relatively early in the postoperative period (5 days to 8 months). The 10 patients in the asymptomatic group all manifested degrees of postoperative epidural scarring on MR, but no abnormal radicular enhancement or other associated pathology.

CONCLUSION In the chronic postoperative phase (more than 6 to 8 months), the presence of radicular enhancement on MR imaging in symptomatic individuals, and its absence in asymptomatic subjects, suggests that neural enhancement serves as a marker for active neural pathology that may in certain individuals be related temporally to the signs and symptoms associated with the lumbosacral postsurgical syndrome.

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American Journal of Neuroradiology
Vol. 14, Issue 2
1 Mar 1993
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Spinal nerve enhancement with Gd-DTPA: MR correlation with the postoperative lumbosacral spine.
J R Jinkins, A G Osborn, D Garrett, S Hunt, J L Story
American Journal of Neuroradiology Mar 1993, 14 (2) 383-394;

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Spinal nerve enhancement with Gd-DTPA: MR correlation with the postoperative lumbosacral spine.
J R Jinkins, A G Osborn, D Garrett, S Hunt, J L Story
American Journal of Neuroradiology Mar 1993, 14 (2) 383-394;
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