Prospective evaluation of contrast-enhanced MR imaging after uncomplicated lumbar discography.

Abstract:

OBJECTIVE:Postdiscography infection is an uncommon complication. Magnetic resonance (MR) imaging is often the modality of choice for evaluating spinal infection. Discography entails disc access and fluid injection that could alter the baseline MR imaging appearance of the spine and be confounded for infection. Our purpose was to describe the MR imaging findings of the lumbar spine subsequent to uncomplicated discography and to determine if this may mimic infection. DESIGN AND PATIENTS:In a prospective cohort study of eight adults (age 22-64 years, mean 45 years) with 22 intradiscal injections, all subjects underwent routine unenhanced and contrast-enhanced MR imaging during the 2-3 week interval postdiscography. A subset of four returned for additional MR imaging during the 4-8 week interval postdiscography. MR images were reviewed for intradiscal, endplate, marrow, and epidural findings and then compared with prediscography examinations. Infection was excluded by clinical documentation. RESULTS:Postdiscography MR imaging showed that almost all levels were similar to baseline prediscography examinations. No levels developed new vertebral marrow edema, fluid-like intradiscal signal, endplate irregularity, or epidural abnormality. Two subjects simulated potential discitis, but these findings were unchanged from prediscography and were related to prior surgery. CONCLUSIONS:Uncomplicated lumbar spine discography does not cause MR imaging changes that simulate discitis.

journal_name

Skeletal Radiol

journal_title

Skeletal radiology

authors

Carrino JA,Swathwood TC,Morrison WB,Glover JM

doi

10.1007/s00256-006-0221-2

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

293-9

issue

4

eissn

0364-2348

issn

1432-2161

journal_volume

36

pub_type

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