The Use of Magnetic Resonance Imaging to Predict the Clinical Outcome of Non-Surgical Treatment for Lumbar Interverterbal Disc Herniation.
- Author:
Soo Jung CHOI
1
;
Jae Seok SONG
;
Chunghwan KIM
;
Myung Jin SHIN
;
Dae Sik RYU
;
Jae Hong AHN
;
Seung Moon JUNG
;
Man Soo PARK
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Spine, intervertebral disks; Spine, MR
- MeSH: Adolescent; Adult; Aged; Chi-Square Distribution; Female; Humans; Intervertebral Disk Displacement/*drug therapy/pathology; Lumbar Vertebrae; *Magnetic Resonance Imaging; Male; Middle Aged; Predictive Value of Tests; Steroids/*therapeutic use; Treatment Outcome
- From:Korean Journal of Radiology 2007;8(2):156-163
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: We wanted to investigate the relationship between the magnetic resonance (MR) findings and the clinical outcome after treatment with non-surgical transforaminal epidural steroid injections (ESI) for lumbar herniated intervertebral disc (HIVD) patients. MATERIALS AND METHODS: Transforaminal ESI were performed in 91 patients (50 males and 41 females, age range: 13-78 yrs) because of lumbosacral HIVD from March 2001 to August 2002. Sixty eight patients whose MRIs and clinical follow-ups were available were included in this study. The medical charts were retrospectively reviewed and the patients were divided into two groups; the successful (responders, n = 41) and unsatisfactory (non-responders, n = 27) outcome groups. A successful outcome required a patient satisfaction score greater than two and a pain reduction score greater than 50%. The MR findings were retrospectively analyzed and compared between the two groups with regard to the type (protrusion, extrusion or sequestration), hydration (the T2 signal intensity), location (central, right/left central, subarticular, foraminal or extraforaminal), and size (volume) of the HIVD, the grade of nerve root compression (grade 1 abutment, 2 displacement and 3 entrapment), and an association with spinal stenosis. RESULTS: There was no significant difference between the responders and non-responders in terms of the type, hydration and size of the HIVD, or an association with spinal stenosis (p > 0.05). However, the location of the HIVD and the grade of nerve root compression were different between the two groups (p < 0.05). CONCLUSION: MRI could play an important role in predicting the clinical outcome of non-surgical transforaminal ESI treatment for patients with lumbar HIVD.
