MRI诊断腰椎间盘术后粘连和突出复发

MRI in the Differentiation of Recurrent Disc Herniation from Epidurl Fibrotic Scar

失败的下腰椎手术是个复杂的问题，由于其症状和体征不典型，单靠临床检查很难明确诊断，而脊髓造影和常规ＣＴ等检查也很难区别突出复发和硬膜外粘连。本文分析了３２例再手术患者ＭＲＩ图象，并与第二次手术所见对比，发现２７例（８４．４％）ＭＲＩ诊断准确，３例假阳性，２例因信号缺失不能明确诊断。作者指出ＭＲＩ能较清晰地显示突出复发和术后粘连。作者同时强调了ＭＲＩ图象与临床表现相结合的重要性。

The failed back surgery syndron(FBSS)is a diagnostic challenge to surgeons because its signs and symptoms are frequental nonspecific. CT and myelography can not provide enough in-formation on differentiation of recurrent disc herniation from epidural fibrotic scar. 32 cases with FBSS which had undergone reoperation were analyzed. MRI had been applied for all of them be-fore the second operation,and among them the diagnoses of 27 cases(84.4%)were found to be e-orrect as observed during the second operation,3 cases were found false-positive and 2cases could not be valued because of the artifact.The authors pointed out that MRI could provide adequate in-formation for differentiating epidural fibrotic scar and recurrent disc herniation. The authors also emphasized the importance of combination of MRI and clinical findings.