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Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?

BACKGROUND: A postoperative magnetic resonance imaging (MRI) is performed as a routine to assess decompression of the spinal cord as well as to evaluate postoperative complications. The purpose of this study is to analyze the efficacy of postoperative MRI for hematoma in spinal decompression surgery...

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Autores principales: Shin, Hun-Kyu, Jeong, Hwa-Jae, Kim, Eugene, Park, Jai Hyung, Park, Se-Jin, Cho, Yongun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435656/
https://www.ncbi.nlm.nih.gov/pubmed/28567220
http://dx.doi.org/10.4055/cios.2017.9.2.184
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author Shin, Hun-Kyu
Jeong, Hwa-Jae
Kim, Eugene
Park, Jai Hyung
Park, Se-Jin
Cho, Yongun
author_facet Shin, Hun-Kyu
Jeong, Hwa-Jae
Kim, Eugene
Park, Jai Hyung
Park, Se-Jin
Cho, Yongun
author_sort Shin, Hun-Kyu
collection PubMed
description BACKGROUND: A postoperative magnetic resonance imaging (MRI) is performed as a routine to assess decompression of the spinal cord as well as to evaluate postoperative complications. The purpose of this study is to analyze the efficacy of postoperative MRI for hematoma in spinal decompression surgery. METHODS: Between January 1, 2008 and January 31, 2015, 185 patients who underwent postoperative MRI after spinal decompression surgery were included in this study. We checked the history of the use of an anticoagulant or antiplatelet agent, withdrawal period, blood platelet count, and prothrombin time (international normalized ratio [INR]). We measured the total amount of suction drainage and duration until removal. We retrospectively reviewed the presence of hematoma and thecal sac compression. Postoperative prognosis was evaluated by a visual analog scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Hematomas were found on postoperative MRI scans in 97 out of 185 patients (52.4%). Thirty patients had a thecal sac compressing hematoma: 7 in the cervical spine, 1 in the thoracic spine, and 22 in the lumbar spine. The occurrence of hematoma did not show significant difference according to the use of an anticoagulant (p = 0.157). The blood platelet count, prothrombin time (INR), and suction drainage duration did not have a statistically significant correlation with the occurrence of hematoma (p = 0.562, p = 0.506, and p = 0.429, respectively). The total amount of suction drainage was significantly different according to the presence of hematoma (p = 0.022). The total 185 patients had a significant decrease in the postoperative VAS score (p < 0.001), and the diminution of VAS score was not significantly different according to the occurrence of hematoma (p = 0.243). Even in the cases of thecal sac compressing hematoma, the reduction of VAS score was not significantly different (p = 0.689). CONCLUSIONS: Postoperative MRI for hematoma in spinal decompression surgery has little effect on prognosis or management. Therefore, indiscriminate postoperative MRI should be avoided and MRI should be performed depending on the patient's status.
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spelling pubmed-54356562017-06-01 Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery? Shin, Hun-Kyu Jeong, Hwa-Jae Kim, Eugene Park, Jai Hyung Park, Se-Jin Cho, Yongun Clin Orthop Surg Original Article BACKGROUND: A postoperative magnetic resonance imaging (MRI) is performed as a routine to assess decompression of the spinal cord as well as to evaluate postoperative complications. The purpose of this study is to analyze the efficacy of postoperative MRI for hematoma in spinal decompression surgery. METHODS: Between January 1, 2008 and January 31, 2015, 185 patients who underwent postoperative MRI after spinal decompression surgery were included in this study. We checked the history of the use of an anticoagulant or antiplatelet agent, withdrawal period, blood platelet count, and prothrombin time (international normalized ratio [INR]). We measured the total amount of suction drainage and duration until removal. We retrospectively reviewed the presence of hematoma and thecal sac compression. Postoperative prognosis was evaluated by a visual analog scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Hematomas were found on postoperative MRI scans in 97 out of 185 patients (52.4%). Thirty patients had a thecal sac compressing hematoma: 7 in the cervical spine, 1 in the thoracic spine, and 22 in the lumbar spine. The occurrence of hematoma did not show significant difference according to the use of an anticoagulant (p = 0.157). The blood platelet count, prothrombin time (INR), and suction drainage duration did not have a statistically significant correlation with the occurrence of hematoma (p = 0.562, p = 0.506, and p = 0.429, respectively). The total amount of suction drainage was significantly different according to the presence of hematoma (p = 0.022). The total 185 patients had a significant decrease in the postoperative VAS score (p < 0.001), and the diminution of VAS score was not significantly different according to the occurrence of hematoma (p = 0.243). Even in the cases of thecal sac compressing hematoma, the reduction of VAS score was not significantly different (p = 0.689). CONCLUSIONS: Postoperative MRI for hematoma in spinal decompression surgery has little effect on prognosis or management. Therefore, indiscriminate postoperative MRI should be avoided and MRI should be performed depending on the patient's status. The Korean Orthopaedic Association 2017-06 2017-05-08 /pmc/articles/PMC5435656/ /pubmed/28567220 http://dx.doi.org/10.4055/cios.2017.9.2.184 Text en Copyright © 2017 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shin, Hun-Kyu
Jeong, Hwa-Jae
Kim, Eugene
Park, Jai Hyung
Park, Se-Jin
Cho, Yongun
Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?
title Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?
title_full Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?
title_fullStr Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?
title_full_unstemmed Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?
title_short Should We Check the Routine Postoperative MRI for Hematoma in Spinal Decompression Surgery?
title_sort should we check the routine postoperative mri for hematoma in spinal decompression surgery?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435656/
https://www.ncbi.nlm.nih.gov/pubmed/28567220
http://dx.doi.org/10.4055/cios.2017.9.2.184
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