The Value Of Early Postoperative Contrast-enhanced MR Neurography After Lumbar Microdiscetomy

Background and objective Conventional magnetic resonance imaging(MRI)sequence is of limited value in early postoperative check for patients with lumbar disc herniation(LDH).Enhanced magnetic resonance neurography(MRN)can well display nerve morphology and manifestation of compression,but it has not been applied in follow up in postoperative LDH patients.The purpose of this study is to evaluate the correlation between enhanced MRN and clinical symptoms in LDH patients after minimally invasive surgery and to explore the value of this technique in reexamination of LDH patients after operation.Material and Methods 22 hospitalized patients whom had lumbar disk herniation and underwent minimally invasive surgery were collected,they were performed symptom assessment,conventional MR scan and contrast-enhanced MRN examination pre-and three months after surgery,MR examination of routine(comprehensive analysis)and contrast-enhanced MRN(nerve compression degree)were analyzed for semiquantitative evaluation,their differences between pre-and post-surgery were compared and correlation between symptom ratings were evaluated.Results Recovery of symptoms: 22 patients(male 11,female 11,mean age 38.1)recovered markedly after operation,13 of them recovered well,and 9 recovered poorly;Routine MR performance: 3 months after operation,the routine MR manifestation of all patients showed no significant changes compared with the preoperative performance,and there was no significant correlation with the change of clinical symptoms(X~2=1.96,P=0.658>0.05).Contrast-enhanced MRN performance: all patients showed improved MRN manifestation in 3 months after operation,11 cases showed obvious nerve decompression,and 11 cases showed poor recovery of nerve decompression,and MRN recovery showed a high consistency with clinical symptoms changes(X~2=4.701,P=0.03<0.05).Conclusion 1.The contrast-enhanced MRN is more sensitive to decompression of nerve root after LDH discectomy than that of routine MR examination,and has good correlation with clinical symptom recovery.It has high value and good application prospect in early postoperative reexamination after discectomy in LDH;2.The contrast-enhanced MRN sequence can welly display lumbosacral plexus,which can better display nerve compression than the conventional MR sequences,which is of great significance for second surgery planning in poor recovered postoperative patients.