Neuroimaging clinics of North America
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Few tasks in imaging are more challenging than that of optimizing evaluations of the instrumented spine. The authors describe how applying fundamental and more advanced principles to postoperative spine computed tomography and magnetic resonance examinations mitigates the challenges associated with metal implants and significantly improves image quality and consistency. Newer and soon-to-be-available enhancements should provide improved visualization of tissues and hardware as multispectral imaging sequences continue to develop.
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Although imaging plays a critical role and has become an integral part in preprocedure evaluation of osteoporotic patients at risk of compression fracture, many treated patients undergo follow-up imaging, for reasons ranging from potential procedure-related complications to development of new symptoms after initial improvement after successful vertebral augmentation (VA). Although imaging is frequently obtained for evaluation of these patients, there is a general lack of knowledge about imaging characteristics of treated vertebrae. This article reviews various indications for post-VA imaging, the appearance of augmented spine on imaging, and the important complications associated with the VA procedure.
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This article reviews the imaging of lumbar spinal fusion and its major indications. The most common procedures are described for the purpose of allowing understanding of postoperative imaging. Imaging options are reviewed for preoperative workup, intraoperative guidance, and postoperative purposes. Examples of hardware integrity, fusion, and loosening are provided.
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Neuroimaging Clin. N. Am. · May 2014
ReviewRadiologic evaluation and management of postoperative spine paraspinal fluid collections.
Postoperative paraspinal fluid collections can present a management dilemma to both radiologists and surgeons. Although many of these collections present as incidental findings and are unrelated to the presenting signs and symptoms that led to the imaging study, certain collections in the context of the appropriate clinical scenario may require additional evaluation and even emergent intervention. This article reviews those collections that are most frequently encountered and suggests management strategies that may assist in the evaluation and management of the patient.
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Imaging of the postoperative spine is common, although it remains a difficult task for radiologists. This article presents an overview of common surgical approaches and spinal hardware, and specific complications that may be associated with each procedure. In addition, expected postoperative changes and complications that are common among procedures, with their differential diagnosis and imaging features, are discussed.