Postoperative Bildgebung der Wirbelsäule

Die Radiologie, 2022 · DOI: https://doi.org/10.1007/s00117-022-01034-2 · Published: July 5, 2022

Simple Explanation

Postoperative spinal imaging primarily aims to verify surgical success and detect complications. Radiologists select suitable imaging techniques based on pre-operative conditions, surgical procedures, and post-operative symptoms. Imaging faces technical challenges due to implanted materials. Radiologists differentiate between expected post-operative changes and significant complications, requiring communication with patients and clinicians. Immediate diagnosis is crucial for clinical signs of infection, new neurological deficits, or cauda equina syndrome to ensure swift therapeutic intervention.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Conventional X-rays are used for postoperative implant placement and integrity checks, and are the first choice for routine examinations.
2
CT scans provide excellent bone contrast for assessing vertebral alignment, fractures, and implant positioning, and can also reveal larger postoperative fluid collections or suspected infections.
3
MRI is the gold standard for spinal imaging due to its excellent soft tissue contrast, multiparametric imaging capabilities, and lack of radiation exposure.

Research Summary

Postoperative imaging of the spine serves to control the success of the operation and to identify complications. Conventional X-ray, CT, myelography and MRI are available for this purpose. The radiologist must choose the appropriate modality for sufficient diagnostics, taking into account the preoperative situation, the operation performed, and the postoperative complaint constellation. In the assessment, radiologists are faced with the task of differentiating between natural, expected postoperative changes and relevant complications. A lively exchange with patients and referring clinicians is essential.

Practical Implications

Optimized Imaging Protocols

Implement techniques for metal artifact reduction in CT and MRI to improve image quality around implants.

Differential Diagnosis

Diligently differentiate between normal postoperative changes and pathological complications to guide appropriate management.

Multidisciplinary Collaboration

Foster close communication between radiologists, surgeons, and clinicians for accurate diagnosis and timely intervention.

Study Limitations

1
Metal artifacts can significantly impair image quality, especially in CT and MRI.
2
Distinguishing between postoperative changes and complications can be challenging.
3
Some imaging techniques involve ionizing radiation or invasive procedures.

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