Preoperative Magnetic Resonance Imaging Abnormalities Predictive of Lumbar Herniation Recurrence After Surgical Repair

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dc.authoridAkinci, Ahmet Tolgay/0000-0002-9937-076X
dc.authoridAkgun, Mehmet Yigit/0000-0003-1342-7663
dc.authorwosidAkinci, Ahmet Tolgay/S-9731-2017
dc.authorwosidAkgun, Mehmet Yigit/AAA-2136-2020
dc.contributor.authorKaradag, Mehmet Kursat
dc.contributor.authorAkinci, Ahmet Tolgay
dc.contributor.authorBasak, Ahmet Tulgar
dc.contributor.authorHekimoglu, Mehdi
dc.contributor.authorYildirim, Hakan
dc.contributor.authorAkyoldas, Goktug
dc.contributor.authorAydin, Ahmet Levent
dc.date.accessioned2024-06-12T10:59:12Z
dc.date.available2024-06-12T10:59:12Z
dc.date.issued2022
dc.departmentTrakya Üniversitesien_US
dc.description.abstractOBJECTIVE: There are currently no standard criteria for evaluating the risk of recurrent disk herniation after surgical repair. This study investigated the predictive values of 5 presurgical imaging parameters: paraspinal muscle quality, annular tear size, Modic changes, modified Phirrmann disk degeneration grade, and presence of sacralization or fusion. METHODS: Between 2015 and 2018, 188 patients (89 female, 99 male, median age 50) receiving first corrective surgery for lumbar disk herniation were enrolled. Micro-diskectomy was performed in 161 of these patients, and endoscopic translaminar diskectomy approach was performed in 27 patients. Clinical status was evaluated before surgery and 4, 12, and 24 months post surgery using a visual analog scale, Oswestry Disability Index, and Short Form 36. RESULTS: Recurrent disk herniation was observed in 21 of 188 patients. Seventeen of the recurrent disk herniations were seen in those who underwent microdiskectomy and 4 in those who underwent endoscopic translaminar diskectomy. There were significant differences in visual analog scale, Oswestry Disability Index, and Short Form 36 scores at 4, 12, and 24 months between patients with recurrence and the 167 no-recurrence patients. The median annular tear length was significantly greater in patients with recurrence than without recurrence. In addition, there were significant differences in recurrence rate according to Modic change type distribution, sacralization or fusion presence, Pfirmann disk; degeneration grade distribution, dichotomized annular tear size, dichotomized Modic change; and type and simplified 3-tier muscle degeneration classification distribution. CONCLUSIONS: Patients with poor clinical scores and recurrence exhibited additional radiologic abnormalities before surgery, such as poor paraspinal muscle quality, longer annular tears, higher Modic change type, higher modified Phirrmann disk degeneration grade, and sacralization or fusion. This risk evaluation protocol may prove valuable for patient selection, surgical planning, and choice of postoperative recovery regimen.en_US
dc.identifier.doi10.1016/j.wneu.2022.06.143
dc.identifier.endpageE756en_US
dc.identifier.issn1878-8750
dc.identifier.issn1878-8769
dc.identifier.pmid35803567en_US
dc.identifier.scopus2-s2.0-85134563719en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpageE750en_US
dc.identifier.urihttps://doi.org/10.1016/j.wneu.2022.06.143
dc.identifier.urihttps://hdl.handle.net/20.500.14551/20359
dc.identifier.volume165en_US
dc.identifier.wosWOS:000877381000023en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofWorld Neurosurgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectDegenerative Disk Diseaseen_US
dc.subjectLumbar Disk Herniationen_US
dc.subjectMRI Evaluation Of Lumbar Disk Herniationen_US
dc.subjectRecurrence Disk Herniationen_US
dc.subjectLow-Back-Painen_US
dc.subjectDynamic Stabilizationen_US
dc.subjectInterbody Fusionen_US
dc.subjectDiscen_US
dc.subjectDiskectomyen_US
dc.subjectSystemen_US
dc.subjectClassificationen_US
dc.subjectLevelen_US
dc.subjectSpineen_US
dc.subjectDegenerationen_US
dc.titlePreoperative Magnetic Resonance Imaging Abnormalities Predictive of Lumbar Herniation Recurrence After Surgical Repairen_US
dc.typeArticleen_US

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