MR Myelography is a Useful Addition to Elective Lumbar Spinal Surgery

腰椎手術加作磁振脊椎造影術的臨床經驗

周啟文(Chi-Wen Chou) ； 劉榮東(Jung-Tung Liu) ； 張益彰(I-Chang Chang)

《Journal of Orthopaedic Surgery Taiwan》 22卷3期 (2005/09) Pp. 117-121

並列摘要

Background: An intraspinal tumor may present initially with radicular pain mimicking a low back spinal disorder. Moreover, various diseases may cause multilevel involvement of the spine. These disorders may occasionally be responsible for failed back surgery syndrome.
Materials and Methods: From Jan 1999 to Dec 2001, we examined 253 patients with lumbosacral disorder who came to our office requesting elective lumbar spinal surgery. Patients whom we initially suspected of having an intraspinal tumor were excluded. Spinal stenosis in 221 patients and herniation of intervertebral disc in 32 patients were impressed before the confirmatory image study. All patients were given magnetic resonance imaging (MRI) examinations including a whole spine MRI-myelogram for confirmatory study before spinal surgery.
Results: Eight patients (3.16%) with intraspinal tumors were identified. Tumor excision alone was performed in four patients and tumor excision and lumbar spine decompression were performed in four.
Conclusion: The use of MR myelography to supplement conventional MRI prior to elective lumbar spinal surgery may detect coexistent hidden spinal disorders. A different surgical strategy may be needed if the MRI results show multilevel involvement or suggest an alternative diagnosis. Outcomes are favorable with rapid diagnosis and urgent neurological decompression.

並列關鍵字

failed back surgery syndrome ； intraspinal tumor ； MR myelography