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Spine imaging after lumbar disc replacement: pitfalls and current recommendations
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
2009 (English)In: Patient safety in surgery, ISSN 1754-9493, Vol. 3, no 1, 15- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Most lumbar artificial discs are still composed of stainless steel alloys, which prevents adequate postoperative diagnostic imaging of the operated region when using magnetic resonance imaging (MRI). Thus patients with postoperative radicular symptoms or claudication after stainless steel implants often require alternative diagnostic procedures. METHODS: Possible complications of lumbar total disc replacement (TDR) are reviewed from the available literature and imaging recommendations given with regard to implant type. Two illustrative cases are presented in figures. RESULTS: Access-related complications, infections, implant wear, loosening or fracture, polyethylene inlay dislodgement, facet joint hypertrophy, central stenosis, and ankylosis of the operated segment can be visualised both in titanium and stainless steel implants, but require different imaging modalities due to magnetic artifacts in MRI. CONCLUSION: Alternative radiographic procedures should be considered when evaluating patients following TDR. Postoperative complications following lumbar TDR including spinal stenosis causing radiculopathy and implant loosening can be visualised by myelography and radionucleotide techniques as an adjunct to plain film radiographs. Even in the presence of massive stainless steel TDR implants lumbar radicular stenosis and implant loosening can be visualised if myelography and radionuclide techniques are applied.

Place, publisher, year, edition, pages
2009. Vol. 3, no 1, 15- p.
National Category
Surgery
Research subject
Orthopaedics
Identifiers
URN: urn:nbn:se:uu:diva-113114DOI: 10.1186/1754-9493-3-15PubMedID: 19619332OAI: oai:DiVA.org:uu-113114DiVA: diva2:289802
Available from: 2010-01-25 Created: 2010-01-25 Last updated: 2010-04-21Bibliographically approved

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