Fast spin-echo MR assessment of patients with poor outcome following spinal cervical surgery

Purpose: The aim of the investigation was to evaluate-poor outcome following spinal cervical surgery. Material and Methods. A total of 146 consecutive patients operated with anterior discectomy and fusion (ADF) with the Cloward technique were investigated. Clinical notes, plain radiography, CT. and fast spin-echo (FSE) images were retrospectively evaluated. Results: Some 30% of the patients had unsatisfactory clinical results within 12 months after surgery, 13% had initial improvement followed by deterioration of the preoperative symptoms, while 14.4% were not improved or worsened. Disc herniation and bony stenosis above, below, or at the fused level were the most common findings. In 45% of patients, surgery failed to decompress the spinal canal. In only 4 patients was no cause of remaining myelopathy and/or radiculopathy found. FSE demonstrated a large variety of pathological findings in the patients with poor clinical out come after ADF. Postoperatively, patients with good clinical outcome had a lower incidence of pathological changes. Conclusion: FSE is considered the primary imaging modality for the cervical spine. However, CT is a useful complement in the axial projection to visualize bone changes.