Käfer W, Heumüller I, Harsch N, Kraus C, Reith W
Abteilung für Wirbelsäulenchirurgie, Westpfalzklinikum GmbH, Standort II, Kusel, Deutschland.
Institut für Radiologie II, Westpfalzklinikum GmbH, Standort II, Kusel, Deutschland.
Radiologe. 2016 Aug;56(8):698-707. doi: 10.1007/s00117-016-0130-x.
As a rule, postoperative imaging is carried out after spinal interventions to document the exact position of the implant material.
Imaging is absolutely necessary when new clinical symptoms occur postoperatively. In this case a rebleeding or an incorrect implant position abutting a root or the spinal cord must be proven. In addition to these immediately occurring postoperative clinical symptoms, there are a number of complications that can occur several days, weeks or even months later. These include the failed back surgery syndrome, implant loosening or breakage of the material and relapse of a disc herniation and spondylodiscitis.
In addition to knowledge of the original clinical symptoms, it is also important to know the operation details, such as the access route and the material used.
In almost all postoperative cases, imaging with contrast medium administration and corresponding correction of artefacts by the implant material, such as the dual energy technique, correction algorithms and the use of special magnetic resonance (MR) sequences are necessary.
In order to correctly assess the postoperative imaging, knowledge of the surgical procedure and the previous clinical symptoms are mandatory besides special computed tomography (CT) techniques and MR sequences.
通常,脊柱干预术后需进行影像学检查,以记录植入材料的确切位置。
术后出现新的临床症状时,影像学检查绝对必要。在这种情况下,必须证实存在再出血或植入物位置不当,压迫神经根或脊髓。除了这些术后立即出现的临床症状外,还会有一些并发症在数天、数周甚至数月后出现。这些并发症包括腰椎手术失败综合征、植入物松动或材料断裂以及椎间盘突出复发和脊椎椎间盘炎。
除了了解原始临床症状外,了解手术细节也很重要,如手术入路和所用材料。
在几乎所有术后病例中,需要进行使用造影剂的影像学检查,并通过植入材料对伪影进行相应校正,如双能技术、校正算法以及使用特殊磁共振(MR)序列。
为了正确评估术后影像学检查结果,除了特殊的计算机断层扫描(CT)技术和MR序列外,还必须了解手术过程和先前的临床症状。