Evangelos I Papanastasiou1, Daphne J Theodorou2, Stavroula J Theodorou3, Emilios E Pakos4, Avraam Ploumis5, Anastasios V Korompilias4, Ioannis D Gelalis4. 1. Department of Orthopaedic Surgery, University of Ioannina School of Medicine, Ioannina, Greece. vangelispapanastasiou@yahoo.gr. 2. Department of Radiology, General Hospital of Ioannina, Ioannina, Greece. 3. Department of Radiology, University Hospital of Ioannina, Ioannina, Greece. 4. Department of Orthopaedic Surgery, University of Ioannina School of Medicine, Ioannina, Greece. 5. Physical Medicine and Rehabilitation Clinic, University of Ioannina Medical School, Ioannina, Greece.
Abstract
BACKGROUND: To evaluate the associations between magnetic resonance imaging (MRI) findings and pain, disability and quality of life before surgery and up to 5 years after lumbar microdiscectomy. MATERIALS AND METHODS: Sixty-one patients who underwent one-level lumbar microdiscectomy by the same surgeon participated in this analytic, observational, prospective study. Lumbar spine MRI was performed preoperatively and 5 years postoperatively. Pain, disability and quality of life were measured with VAS, ODI, Roland Morris and SF-36 pre- and up to 5 years postoperatively. Subsequently associations between radiological findings and clinical outcomes were recorded. RESULTS: Before surgery patients with disc extrusion or sequestration, with increased thecal sac compression (d > 2/3), with Modic changes (MC) 2 and 3 on the operated level and Pfirrmann grades IV and V on the operated and both adjacent discs presented the worst preoperative clinical outcomes. MC preoperatively were not related with postoperative results, in contrast with the type of disc herniation and thecal sac compression. Preoperative Pfirrmann grade IV and V on the operated and both adjacent discs and postoperative MC 2 and 3 on the operated level were related to poor clinical outcomes 36-60 months post-discectomy. CONCLUSIONS: Extrusion or sequestration of the operated disc, increased compression of thecal sac, MC 2 and 3 on the operated level and Pfirrmann grades IV and V on the operated and adjacent discs were associated with the worst clinical outcomes. Nerve root impingement, facet joint arthritis, perineural fibrosis and disc granulation tissue had no effect on clinical scores.
BACKGROUND: To evaluate the associations between magnetic resonance imaging (MRI) findings and pain, disability and quality of life before surgery and up to 5 years after lumbar microdiscectomy. MATERIALS AND METHODS: Sixty-one patients who underwent one-level lumbar microdiscectomy by the same surgeon participated in this analytic, observational, prospective study. Lumbar spine MRI was performed preoperatively and 5 years postoperatively. Pain, disability and quality of life were measured with VAS, ODI, Roland Morris and SF-36 pre- and up to 5 years postoperatively. Subsequently associations between radiological findings and clinical outcomes were recorded. RESULTS: Before surgery patients with disc extrusion or sequestration, with increased thecal sac compression (d > 2/3), with Modic changes (MC) 2 and 3 on the operated level and Pfirrmann grades IV and V on the operated and both adjacent discs presented the worst preoperative clinical outcomes. MC preoperatively were not related with postoperative results, in contrast with the type of disc herniation and thecal sac compression. Preoperative Pfirrmann grade IV and V on the operated and both adjacent discs and postoperative MC 2 and 3 on the operated level were related to poor clinical outcomes 36-60 months post-discectomy. CONCLUSIONS: Extrusion or sequestration of the operated disc, increased compression of thecal sac, MC 2 and 3 on the operated level and Pfirrmann grades IV and V on the operated and adjacent discs were associated with the worst clinical outcomes. Nerve root impingement, facet joint arthritis, perineural fibrosis and disc granulation tissue had no effect on clinical scores.
Entities:
Keywords:
Disability; Lumbar microdiscectomy; MRI findings; Pain; Quality of life
Authors: Ioannis D Gelalis; Evangelos I Papanastasiou; Daphne J Theodorou; Stavroula J Theodorou; Emilios E Pakos; Efthimios Samoladas; Dimitrios V Papadopoulos; Maria Mantzari; Anastasios V Korompilias Journal: Eur J Orthop Surg Traumatol Date: 2018-11-08
Authors: Ioannis D Gelalis; Evangelos I Papanastasiou; Emilios E Pakos; Avraam Ploumis; Dimitrios Papadopoulos; Maria Mantzari; Ioannis S Gkiatas; Marios D Vekris; Anastasios V Korompilias Journal: Eur J Orthop Surg Traumatol Date: 2018-12-06
Authors: Jon D Lurie; Rachel A Moses; Anna N A Tosteson; Tor D Tosteson; Eugene J Carragee; John A Carrino; Jay A Kaiser; Richard J Herzog Journal: Spine (Phila Pa 1976) Date: 2013-06-15 Impact factor: 3.468
Authors: Kenneth M C Cheung; Jaro Karppinen; Danny Chan; Daniel W H Ho; You-Qiang Song; Pak Sham; Kathryn S E Cheah; John C Y Leong; Keith D K Luk Journal: Spine (Phila Pa 1976) Date: 2009-04-20 Impact factor: 3.468