Spine imaging after lumbar disc replacement: pitfalls and current recommendationsReport as inadecuate




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Patient Safety in Surgery

, 3:15

First Online: 20 July 2009Received: 09 April 2009Accepted: 20 July 2009

Abstract

BackgroundMost lumbar artificial discs are still composed of stainless steel alloys, which prevents adequate postoperative diagnostic imaging of the operated region when using magnetic resonance imaging MRI. Thus patients with postoperative radicular symptoms or claudication after stainless steel implants often require alternative diagnostic procedures.

MethodsPossible complications of lumbar total disc replacement TDR are reviewed from the available literature and imaging recommendations given with regard to implant type. Two illustrative cases are presented in figures.

ResultsAccess-related complications, infections, implant wear, loosening or fracture, polyethylene inlay dislodgement, facet joint hypertrophy, central stenosis, and ankylosis of the operated segment can be visualised both in titanium and stainless steel implants, but require different imaging modalities due to magnetic artifacts in MRI.

ConclusionAlternative radiographic procedures should be considered when evaluating patients following TDR. Postoperative complications following lumbar TDR including spinal stenosis causing radiculopathy and implant loosening can be visualised by myelography and radionucleotide techniques as an adjunct to plain film radiographs. Even in the presence of massive stainless steel TDR implants lumbar radicular stenosis and implant loosening can be visualised if myelography and radionuclide techniques are applied.

Electronic supplementary materialThe online version of this article doi:10.1186-1754-9493-3-15 contains supplementary material, which is available to authorized users.

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Author: Yohan Robinson - Bengt Sandén

Source: https://link.springer.com/article/10.1186/1754-9493-3-15







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