Lumbar spinal fusion. Assessment of functional stability with magnetic resonance imaging.

Abstract:

:Segmental spinal instability was evaluated with magnetic resonance (MR) imaging, computed tomography (CT), and conventional radiography in 33 patients who had undergone surgical spinal fusion. In 16 of the 19 patients who had a diagnosis of solid fusion, the immobilized vertebral bodies demonstrated areas of high signal intensity on images with short repetition time (TR) and echo time (TE). The signal intensity of these areas was either less intense or normal on images with long TR and TE. In 10 of the 14 patients with segmental instability at the fusion site, subchondral vertebral bands of low signal intensity were shown on short TR/TE images, which demonstrated high signal intensity on long TR/TE images. All but two of the patients showed vertebral signal changes 12 or more months past fusion or onset of clinical symptoms. The vertebral MR signal intensity in solid lumbar fusions might be related to marrow composition changes resulting from decreased biomechanical stress, while the vertebral signal intensities in patients with unstable fusions might be related to reparative granulation tissue, inflammation, edema, and hyperemic changes. Magnetic resonance imaging appears to be unique in its assessment of functional fusion stability. Magnetic resonance may be most useful in patients symptomatic of fusion pseudarthrosis in whom conventional radiography and CT fail to demonstrate anatomic disruption.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Lang P,Chafetz N,Genant HK,Morris JM

doi

10.1097/00007632-199006000-00028

subject

Has Abstract

pub_date

1990-06-01 00:00:00

pages

581-8

issue

6

eissn

0362-2436

issn

1528-1159

journal_volume

15

pub_type

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