Publication:
Preoperative magnetic resonance imaging abnormalities predictive of lumbar herniation recurrence after surgical repair

dc.contributor.coauthorKaradag, Mehmet Kursat
dc.contributor.coauthorAkinci, Ahmet Tolgay
dc.contributor.coauthorBasak, Ahmet Tulgar
dc.contributor.coauthorHekimoglu, Mehdi
dc.contributor.coauthorYildirim, Hakan
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorAkgün, Mehmet Yiğit
dc.contributor.kuauthorAkyoldaş, Göktuğ
dc.contributor.kuauthorAteş, Özkan
dc.contributor.kuauthorAydın, Ahmet Levent
dc.contributor.kuauthorGünerbüyük, Caner
dc.contributor.kuauthorÖktenoğlu, Bekir Tunç
dc.contributor.kuauthorÖzer, Ali Fahir
dc.contributor.kuauthorSasani, Mehdi
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T23:25:14Z
dc.date.issued2022
dc.description.abstractObjective: There are currently no standard criteria for evaluating the risk of recurrent disk herniation after surgical repair. This study investigated the predictive values of 5 presurgical imaging parameters: paraspinal muscle quality, annular tear size, Modic changes, modified Phirrmann disk degeneration grade, and presence of sacralization or fusion. Methods: Between 2015 and 2018, 188 patients (89 female, 99 male, median age 50) receiving first corrective surgery for lumbar disk herniation were enrolled. Micro-diskectomy was performed in 161 of these patients, and endoscopic translaminar diskectomy approach was performed in 27 patients. Clinical status was evaluated before surgery and 4, 12, and 24 months post surgery using a visual analog scale, Oswestry Disability Index, and Short Form 36. Results: Recurrent disk herniation was observed in 21 of 188 patients. Seventeen of the recurrent disk herniations were seen in those who underwent microdiskectomy and 4 in those who underwent endoscopic translaminar diskectomy. There were significant differences in visual analog scale, Oswestry Disability Index, and Short Form 36 scores at 4, 12, and 24 months between patients with recurrence and the 167 no-recurrence patients. The median annular tear length was significantly greater in patients with recurrence than without recurrence. In addition, there were significant differences in recurrence rate according to Modic change type distribution, sacralization or fusion presence, Pfirmann disk; degeneration grade distribution, dichotomized annular tear size, dichotomized Modic change; and type and simplified 3-tier muscle degeneration classification distribution. Conclusions: Patients with poor clinical scores and recurrence exhibited additional radiologic abnormalities before surgery, such as poor paraspinal muscle quality, longer annular tears, higher Modic change type, higher modified Phirrmann disk degeneration grade, and sacralization or fusion. This risk evaluation protocol may prove valuable for patient selection, surgical planning, and choice of postoperative recovery regimen.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume165
dc.identifier.doi10.1016/j.wneu.2022.06.143
dc.identifier.eissn1878-8769
dc.identifier.issn1878-8750
dc.identifier.scopus2-s2.0-85134563719
dc.identifier.urihttps://doi.org/10.1016/j.wneu.2022.06.143
dc.identifier.urihttps://hdl.handle.net/20.500.14288/11346
dc.identifier.wos877381000023
dc.keywordsDegenerative disk disease
dc.keywordsLumbar disk herniation
dc.keywordsMRI evaluation of lumbar disk herniation
dc.keywordsRecurrence disk herniation low-back-pain
dc.keywordsDynamic stabilization
dc.keywordsInterbody fusion
dc.keywordsDisc
dc.keywordsDiskectomy
dc.keywordsSystem
dc.keywordsClassification
dc.keywordsLevel
dc.keywordsSpine
dc.keywordsDegeneration
dc.language.isoeng
dc.publisherElsevier Science Inc
dc.relation.ispartofWorld Neurosurgery
dc.subjectClinical neurology
dc.subjectSurgery
dc.titlePreoperative magnetic resonance imaging abnormalities predictive of lumbar herniation recurrence after surgical repair
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorAkyoldaş, Göktuğ
local.contributor.kuauthorAydın, Ahmet Levent
local.contributor.kuauthorAteş, Özkan
local.contributor.kuauthorÖktenoğlu, Bekir Tunç
local.contributor.kuauthorSasani, Mehdi
local.contributor.kuauthorAkgün, Mehmet Yiğit
local.contributor.kuauthorÖzer, Ali Fahir
local.contributor.kuauthorGünerbüyük, Caner
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
relation.isOrgUnitOfPublicationf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isOrgUnitOfPublicationd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isOrgUnitOfPublication.latestForDiscoveryf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isParentOrgUnitOfPublication055775c9-9efe-43ec-814f-f6d771fa6dee
relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
relation.isParentOrgUnitOfPublication.latestForDiscovery055775c9-9efe-43ec-814f-f6d771fa6dee

Files