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Relevance of Postoperative Magnetic Resonance Pictures in Evaluating Epidural Hematoma After Thoracic Fixation Surgical procedure.

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Relevance of Postoperative Magnetic Resonance Pictures in Evaluating Epidural Hematoma After Thoracic Fixation Surgical procedure.

World Neurosurg. 2017 Nov;107:803-808

Authors: Shin HK, Choi I, Roh SW, Rhim SC, Jeon SR

Summary
BACKGROUND: It’s troublesome to guage the numerous findings of epidural hematoma in magnetic resonance photographs (MRIs) obtained instantly after thoracic posterior screw fixation (PSF).
METHODS: Prospectively, rapid postoperative MRI was carried out in 10 sufferers who underwent thoracic PSF from April to December 2013. Moreover, we retrospectively analyzed the MRIs from three sufferers earlier than hematoma evacuation out of 260 sufferers who underwent thoracic PSF from January 2000 to March 2013.
RESULTS: The MRI findings of 9 out of the 10 sufferers, consecutively collected after thoracic PSF, confirmed neurologic restoration with a well-preserved cerebrospinal fluid (CSF) house and no distinguished hemorrhage. Despite the fact that there have been metallic artifacts on the degree of the pedicle screws, the preserved CSF house was noticed. In distinction, the MRI of 1 affected person with poor neurologic consequence demonstrated a typical hematoma and slight spinal wire compression and lowered CSF house. Within the retrospective evaluation of the three sufferers who confirmed particular motor weak point within the decrease extremities after their first thoracic fusion surgical procedure and underwent hematoma evacuation, the magnetic resonance photographs earlier than hematoma evacuation additionally revealed hematoma compressing the spinal wire and diminished CSF house.
CONCLUSIONS: This research exhibits that epidural hematomas might be detected on MRI carried out instantly after thoracic fixation surgical procedure, regardless of metallic artifacts and findings comparable to hematoma inflicting spinal wire compression. Lack of CSF house needs to be thought of to be related to neurologic deficit.

PMID: 28844912 [PubMed – indexed for MEDLINE]

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