Predictors of lumbar spine surgical outcomes ID'ed

MRI Findings Linked to Effect of Lumbar Spine Surgery
MRI Findings Linked to Effect of Lumbar Spine Surgery

HealthDay News -- Certain MRI findings may predict outcomes for patients with lumbar intervertebral disc herniation who undergo lumbar spine surgery, according to researchers.

"Among patients with intervertebral disc herniation, those with thecal sac compression of one-third or more had greater surgical treatment effect than those with small disc herniations and Modic type I changes,"Jon D. Lurie, MD, of the Dartmouth Medical School in Lebanon, N.H., and colleagues reported in Spine. "In addition, patients with nerve root 'compression' and 'displacement' benefit more from surgery than those with minimal nerve root impingement." 

To determine whether baseline MRI findings are associated with differential surgical treatment effect, the researchers retrospectively reviewed images from a cohort of 307 patients treated surgically and non-surgically for lumbar intervertebral disc herniation. They assessed differences in surgery and nonoperative treatment outcomes using Oswestry Disability Index. Average patient age was 41.5 years; 40% were women and 61% were surgically treated with discetomy. 

Modic type I endplate changes had significantly worse outcomes and smaller treatment effect from surgery, the researchers found. Within the surgical group, those with thecal sac compression of one-third or greater showed the greatest improvement and the highest treatment effect. Worse surgical outcomes were observed in patients with minimal nerve root impingement.


References

  1. Luri JD et al. Spine. 2013; 38(14):1216-1225.
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