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Journal of Korean Neurosurgical Society > Volume 26(11); 1997 > Article
Journal of Korean Neurosurgical Society 1997;26(11): 1537-1543.
The Role of CT/Discography in Assessing Postoperative Disc Herniation.
Hyoung Keun Lee, Byung Chan Jeon, Sung Woo Seo, Tae Young Kim, Choong Sun Yoo, Jae Gon Moon, Yong Soon Hwang, Han Kyu Kim, Hwa Dong Lee
1Department of Neurosurgery, College of Medicine, Kosin University, Pusan, Korea.
2Department of Neurosurgery Gilmary Hospital, Ulsan, Korea.
ABSTRACT
Successful management of patients with persistent or recurring pain after lumbar disc surgery requires comprehensive evaluation to accurately localize the anatomic sources of pain. The results of reoperation for recurrent disc herniation are uniformly good, whereas those of reoperation for scar tissue are poor. There have been few studies comparing the ability of enhanced MRI and CT/discography to distinguish between scar tissue and recurrent disc herniation. We evaluated 23 patients with recurring pain after lumbar disc surgery. Two neurosurgeons independently reviewed CT/discography and MRI of each patient before and after gadolinium enhancement. To determine the accuracy, sensitivity, and specificity of each test, responses were compared with surgical findings and CT/discography was found to be more sensitive and specific in distinguishing between scar and recurrent disc herniation. Characteristics associated with recurrent disc herniation include nonenhanced or rim-enhanced abnormality surrounding a low signal on enhanced MRI. and extension of contrast into the epidural space on CT/discography. For determining the need to repeat open disc surgery, combined MRI and CT/discography is more accurate and sensitive than either test alone.
Key Words: Scar tissue; Recurrent disc herniation; CT/discography; Enhanced MRI
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