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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Early recurrence after operations for lumbar disc and spinal canal stenosis, follow-up and assessment of postoperative diagnostic image

Das Frührezidiv nach Operationen an lumbalen Bandscheiben und Spinalkanalstenose, Verlaufsbeobachtung und Beurteilung bildgebender Diagnostik

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  • corresponding author Alan Bani - Neurochirurgische Klinik, Klinikum Duisburg-Wedau, zu den Rehwiesen 9, 47055 Duisburg
  • G. Frahm - Neurochirurgische Klinik, Klinikum Duisburg-Wedau, zu den Rehwiesen 9, 47055 Duisburg
  • W. Hassler - Neurochirurgische Klinik, Klinikum Duisburg-Wedau, zu den Rehwiesen 9, 47055 Duisburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.04.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0275.shtml

Published: April 23, 2004

© 2004 Bani et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

To evaluate the postoperatively performed diagnostics imaging with the clinical finding in accordance with the intra-operative findings.

Methods

Between 1997-2002, 3300 lumbar spine operations were performed in our department. 91 Patients had to be re-operated within 14 days after the first operation. The decision for the second operation was made according to the clinical findings and postoperative diagnostic imaging. The CT scan was the most common investigation (88%), followed by MRI of the lumbar spine (36%), Myelogram with myelo-CT was necessary in (22%) of the patients.

Results

In 53% patients residual free sequestered disc parts were found, of which in 11% an extra-foraminal sequester was found. However, in 17% of the cases no convincing finding was seen. In 6% postoperative epidural haematoma was diagnosed. The CT scan was accurate in only in 48-65% of the cases. The MRI has an accuracy of 86-100%, with or without CT. in follow-up, 71% of the patients were pain free. There was no correlation between the intra-operative finding and the success of the second operation.

Conclusions

The decision to re-operate in the direct postoperative phase depends mainly on clinical finding and secondly diagnostic imaging. An early revision is simple to perform with no scar tissue and can improve the prognosis of the disease in relation to freedom from pain. CT scan is fast, economical and accurate in about 1/3 of the cases. However, the MRI is more accurate in nearly all cases.