Magnetic resonance imaging in low back pain and sciatica with special emphasis on the postdiskectomy period. A study using 0.2 and 0.3 T vertical magnetic fields

摘要

The diagnostic capability of magnetic resonance (MR) imaging at 0.3 T was evaluated and compared with other modalities in patients with previous disk surgery and remaining or recurrent sciatica, and in patients with spondylolisthesis and sciatica. In the early postoperative period after successful lumbar diskectomy, MR showed a large amount of abnormal soft tissue in the anterior epidural space, without correlation with clinical symptoms. In the late postoperative period, contrast-enhanced MR provided the best correlation with surgical findings, compared with CT and myelography, in discriminating recurrent/remaining disk herniation from epidural fibrosis in patients with the lumbar postdiskectomy syndrome. Contrast-enhanced MR could not demonstrate any differences regarding presence and extent of epidural fibrosis between symptomatic and asymptomatic patients. In spondylolisthesis, MR gave excellent information about the root canals and the degree of nerve root stretching and compression, which was not possible to evaluate with myelography. MR at 0.3 T provided information comparable to that reported from examinations performed with superconducting MR scanners, and is well suited as the imaging modality in the evaluation of lumbar spine disorders. After introducing MR at 0.2 and 0.3 T with vertical magnetic fields as the first neuroradiological modality, instead of myelography or CT, in the evaluation of the soft tissues of the lumbar spine in patients with low back pain and sciatica, a significant increase in the number of patients examined, a moderate increase in the total cost of investigations, and a significant decrease in the cost per investigated and per operated patient was noted. (Atomindex citation 25:061802)