Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Neurosurg Rev. 2024 Oct 30;47(1):828. doi: 10.1007/s10143-024-03055-y.
Following spinal fixation, postoperative imaging is routinely performed. The value of routine postoperative imaging and its impact on the surgical decision remains uncertain, especially in degenerative cases. Moreover, routine postoperative imaging is not free and is an ionizing radiation. This study investigated the value of postoperative imaging after uneventful uncomplicated elective posterior lumbar fixation.
This case series retrospectively reviewed the medical records of patients who underwent elective posterior lumbar fixation surgeries at our institution within two years. A series of 98 cases met our selection criteria. Their mean age was 51.2 years. We reviewed the decisions taken after performing the routine postoperative images. We searched for further diagnostic or imaging studies, revision surgery, or an extended hospital stay.
We found no particular decision was made after performing the postoperative imaging after uneventful uncomplicated elective posterior lumbar fixation surgeries. Moreover, there was no change in the hospital stay or the regular postoperative clinical management for all the included patients. No revision surgery was required based on the postoperative routine images.
We found that routine postoperative imaging after posterior fixation of a degenerative lumbar spine is of limited value. A randomized, controlled study is helpful to confirm this finding.
脊柱固定术后通常会进行影像学检查。术后常规影像学检查的价值及其对手术决策的影响尚不确定,尤其是在退行性疾病中。此外,常规术后影像学检查并非免费,且具有电离辐射。本研究旨在探讨无并发症的择期后路腰椎固定术后进行影像学检查的价值。
本病例系列研究回顾性分析了我院在两年内进行择期后路腰椎固定术患者的病历。符合选择标准的患者共有 98 例,平均年龄为 51.2 岁。我们对术后常规影像学检查后的决策进行了评估,包括是否进行了进一步的诊断性或影像学研究、是否进行了翻修手术、是否延长了住院时间等。
我们发现,在无并发症的择期后路腰椎固定术后进行常规影像学检查后,并没有做出特定的决策。此外,所有纳入患者的住院时间或常规术后临床管理均未发生变化。根据术后常规影像学检查,无需进行翻修手术。
我们发现,退行性腰椎后路固定术后进行常规影像学检查的价值有限。需要进行随机对照研究来证实这一发现。