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

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Relevance of Postoperative Magnetic Resonance Photos 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 tough to judge the numerous findings of epidural hematoma in magnetic resonance photos (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. Though there have been metallic artifacts on the stage 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 twine compression and diminished 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 photos earlier than hematoma evacuation additionally revealed hematoma compressing the spinal twine and diminished CSF house.
CONCLUSIONS: This examine reveals that epidural hematomas might be detected on MRI carried out instantly after thoracic fixation surgical procedure, regardless of metallic artifacts and findings reminiscent of hematoma inflicting spinal twine compression. Lack of CSF house ought to be thought-about to be related to neurologic deficit.

PMID: 28844912 [PubMed – indexed for MEDLINE]

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