The Relationship Between Preoperative MRI Findings and Clinical Outcomes in Surgical Treatment of Lumbar Disc Herniation (요추 추간판 탈출증 환자의 수술적 치료에서 수술전 자기 공명 영상 검사 소견과 수술적 치료 결과의 관계)

이승환; HWAN MO LEE (이환모); 권혁민; 윤태환; seong hwan moon (문성환)

The Relationship Between Preoperative MRI Findings and Clinical Outcomes in Surgical Treatment of Lumbar Disc Herniation

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2014, 21(1), pp.24-29
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

이승환 ¹, HWAN MO LEE ¹, 권혁민 ², 윤태환 ², seong hwan moon ¹

¹연세대학교
²연세대학교 의과대학 정형외과학교실

Accredited

ABSTRACT

Study Design: A retrospective study. Objectives: To assess the relationship between surgical outcomes and preoperative MRI findings, a retrospective review was conductedon the surgical outcomes depending on the preoperative MRI findings including type of herniation and Modic changes. Summary of Literature Review: In most reports, the patients that have large disc herniation were expected to have improved surgicaloutcomes. However, there have been controversies regarding the outcomes and Modic changes. Materials and Methods: The retrospective review was conducted in 82 patients who underwent a discectomy for single level lumbardisc herniation. The average follow-up period was 34.2 months. Among their preoperative baseline MRI measurements, the stage of discherniation, degree of nerve root compression, degree of dural sac compression, and Modic change of vertebral endplate were evaluatedfor the subsequent comparison between the preoperative and postoperative changes and ODI score. Results: Patients with extrusion or sequestration type showed significant improvements compared to the patients with protrusion typedisc herniation. By degree of nerve root compression, patients with root compression showed significant improvements compared to thepatients who had contact type. The degree of dural sac compression revealed no correlation with changes in the ODI score. 23 of the 82patients, the preoperative MRI showed a Modic change. Compared to the group who did not show such a Modic change, they turned outto be unrelated to the preoperative and postoperative changes in the ODI score. Conclusion: Patients who had extrusion or sequestration type disc herniation showed a better clinical improvement than protrusiontype. Patients with compression type root lesion showed better clinical improvement than contact type root lesion. No correlation wasnoted regarding the outcomes of the surgical treatment and degree of dural sac compression or Modic changes.

KEYWORDS

Lumbar disc herniation, MRI, Discectomy, Clinical outcome

Citation status

* References for papers published after 2023 are currently being built.

[journal] Spangfort EV / 1972 / A computeraided analysis of 2, 504 operations / Acta Orthop Scand Suppl 142 : 1~95

[journal] Carlisle E / 2005 / Percent spinal canal compromise on MRI utilized for predicting the need for surgical treatment in single-level lumbar intervertebral disc herniation / Spine J 5 : 608~614

[journal] Carragee EJ / 2003 / Clinical outcomes after lumbar discectomy for sciatica : the effects of fragment type and anular competence / J Bone Joint Surg Am 85 : 102~108

[journal] Jensen RK / 2012 / Is the development of Modic changes associated with clinical symptoms? A 14-month cohort study with MRI / Eur Spine J 21 : 2271~2279

[journal] Sorlie A / 2012 / Modic type I changes and recovery of back pain after lumbar microdiscectomy / Eur Spine J 21 : 2252~2258

[journal] Eismont FJ / 1989 / Surgical management of lumbar intervertebral-disc disease / J Bone Joint Surg Am 71 : 1266~1271

[journal] Fardon DF / 2001 / Combined Task Forces of the North American Spine Society ASoSR, American Society of N. Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology / Spine (Phila Pa 1976) 26 : E93~E113

[journal] Pfirrmann CW / 2004 / MR image-based grading of lumbar nerve root compromise due to disk herniation : reliability study with surgical correlation / Radiology 230 : 583~588

[journal] Modic MT / 1988 / Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging / Radiology 166 : 193~199

[journal] Chang Hoon Jeon / 2006 / Validation in the Cross-Cultural Adaptation of the Korean Version of the Oswestry Disability Index / Journal of Korean Medical Science / 대한의학회 21(6) : 1092~1097

[journal] Fairbank JC / 1980 / The Oswestry low back pain disability questionnaire / Physiotherapy 66 : 271~273

[journal] Lee HM / 2001 / Classification and Imaging Study of the Lumbar Disc Herniation / J Korean Soc Spine Surg 8 : 314~320

[journal] Bush K / 1992 / The natural history of sciatica associated with disc pathology : a prospective study with clinical and independent radiologic follow-up / Spine(Phila Pa 1976) 17 : 1205~1212

[journal] Hagen KB / 2000 / The Cochrane review of bed rest for acute low back pain and sciatica / Spine(Phila Pa 1976) 25 : 2932~2939

KJCKorea
Journal Central

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03