From the Russell H. Morgan Department of Radiology and Radiologic Science (N.G., P.H.Y., K.C.), Sections of Body CT (E.K.F.) and Musculoskeletal Radiology (J.F.), Johns Hopkins Hospital, 601 N Caroline St, Room 3014, Baltimore, MD 21287; and Spine Division, Department of Orthopedics, Balgrist University Hospital Zurich, Zurich, Switzerland (M.F.).
Radiographics. 2019 Oct;39(6):1840-1861. doi: 10.1148/rg.2019190050.
During the past 2 decades, the number of spinal surgeries performed annually has been steadily increasing, and these procedures are being accompanied by a growing number of postoperative imaging studies to interpret. CT is accurate for identifying the location and integrity of implants, assessing the success of decompression and intervertebral arthrodesis procedures, and detecting and characterizing related complications. Although postoperative spinal CT is often limited owing to artifacts caused by metallic implants, parameter optimization and advanced metal artifact reduction techniques, including iterative reconstruction and monoenergetic extrapolation methods, can be used to reduce metal artifact severity and improve image quality substantially. Commonly used and recently available spinal implants and prostheses include screws and wires, static and extendable rods, bone grafts and biologic materials, interbody cages, and intervertebral disk prostheses. CT assessment and the spectrum of complications that can occur after spinal surgery and intervertebral arthroplasty include those related to the position and integrity of implants and prostheses, adjacent segment degeneration, collections, fistulas, pseudomeningoceles, cerebrospinal fluid leaks, and surgical site infections. Knowledge of the numerous spinal surgery techniques and devices aids in differentiating expected postoperative findings from complications. The various types of spinal surgery instrumentation and commonly used spinal implants are reviewed. The authors also describe and illustrate normal postoperative spine findings, signs of successful surgery, and the broad spectrum of postoperative complications that can aid radiologists in generating reports that address issues that the surgeon needs to know for optimal patient management.RSNA, 2019.
在过去的 20 年中，每年进行的脊柱手术数量稳步增加，并且这些手术伴随着越来越多的术后影像学研究来解读。CT 可准确识别植入物的位置和完整性，评估减压和椎间关节融合术的成功率，并检测和描述相关并发症。尽管由于金属植入物引起的伪影，术后脊柱 CT 通常受到限制，但可以使用参数优化和先进的金属伪影减少技术，包括迭代重建和单能量外推方法，来显著降低金属伪影的严重程度并提高图像质量。常用的和最近可用的脊柱植入物和假体包括螺钉和线材、静态和可扩展棒、骨移植物和生物材料、椎间笼以及椎间盘假体。CT 评估和脊柱手术后和椎间关节置换术后可能发生的并发症谱包括与植入物和假体的位置和完整性、相邻节段退变、积聚、瘘管、假性脑膜膨出、脑脊液漏和手术部位感染相关的并发症。了解众多脊柱手术技术和器械有助于将预期的术后发现与并发症区分开来。本文回顾了各种类型的脊柱手术器械和常用的脊柱植入物。作者还描述和说明了正常的术后脊柱表现、手术成功的迹象以及广泛的术后并发症，这有助于放射科医生生成报告，解决外科医生需要了解的问题，以实现最佳的患者管理。RSNA，2019 年。
