요배부 수술 실패 증후군에서 자기공명영상의 이용 = The Magnetic Resonance Imaging on the Failed Back Surgery Syndrome

다국어 초록 (Multilingual Abstract)

This study was compared pre-operative MRI finding with operative finding on 36 cases with the failed back surgery syndrome
(FBSS) retrospectively. The purpose of this study was to determine the accuracy of the MRI on the FBSS including early complications such as hematoma of infection.
Of the 51 patients with FBSS, we analyzed pre-operative MRI finding compared with operative finding on 36 cases excluding nonunion, instability, metal failure and pseudoarthrosis who underwent an operation for the FBSS from December 1994 to June 1997. There were 25 men (69.4%) and 11 women (30.6%), aged from 16 to 68 years (average 43.6 years). These were divided into 5 sub-groups and calculated sensitivity, specificity and positive predictability.
MRI accuracy in recurred disc was 84%, scar adhesion, recurred or developed stenosis, infection and hematoma 100% each and all, overall accuracy of the MRI 93%, respectively. Average interval of re-operation in FBSS WAS 4.3 years. In the 18 cases (50%), symptoms persist without pain-free interval after first operation. Early complications including hematoma and infection are easily detected with MRI. Especially if patient complains of severe leg pain or neurologic deficit, it is a good diagnostic procedure to check the MRI. The MRI is a useful method for evaluation of most cases of the FBSS, but it has limitations to evaluate recurred disc or scar adhesion only in T1, T2 weighted image. Therefore Gd-DTPA enhancement is necessary for the accurate diagnosis.