Dural Scarring and Repair Issues
Background A vast majority (up to 80%) of the US population are estimated to experience an episode of low back pain (LBP) during their lifetime. A subset of these individuals…
Imaging Considerations (Magnetic Resonance, Computed Tomography, Myelography, Plain)
Introduction Regardless of the presence of lumbar instrumentation, recurrent symptoms after a lumbar decompressive surgery are not uncommon; for example, after undergoing microlumbar discectomy up to 12% of patients may…
Indications
Background Revision lumbar spine surgery is predominantly associated with several distinct pathological processes resulting from an initial index surgery. For example, in the treatment of disc herniations, residual stenosis and…
Medical Fitness Evaluation
Introduction One major issue when considering reconstructive spinal surgery is medical fitness for surgery. This is defined as an individual’s ability to sustain the physiological stress of surgery and recovery….
Anatomy and Physiology/Biology of Bone
Anatomy Lumbar Spine Make-Up The typical vertebral column is composed of 33 vertebrae. The lumbar spine usually has five mobile lumbar vertebrae, denoted as L1–L5. As a group, the lumbar…
The Role of Osteoporosis and Bone Diseases in Revision Spine Surgery
Introduction Poor bone health can lead to failure of the primary spinal procedure and precipitate the need for a revision spine surgery. Postoperative complications related to poor bone health include…
Cerebellopontine Angle Mass Lesions on Magnetic Resonance Imaging
The cerebellopontine angle (CPA) is formed by the lateral pons and the cerebellum around the level of the middle cerebellar peduncle. At the CPA, there is a triangular extraaxial subarachnoid…
Sellar Lesions on Magnetic Resonance Imaging
The pituitary gland resides in the sella turcica, a depression in the sphenoid bone, and is subdivided into an anterior portion, composed of hormone-secreting cells, and a posterior portion, composed…
Ring-Enhancing Lesions on Magnetic Resonance Imaging
Gadolinium-based intravenous contrast agents used in magnetic resonance imaging (MRI) appear hyperintense on T1 sequences. These agents do not cross the blood–brain barrier in normal patients, and thus T1 hyperintensity…
White Matter Lesions on Magnetic Resonance Imaging
White matter lesions (WMLs), also called white matter hyperintensities, are a common finding on T2 and fluid-attenuated inversion recovery (FLAIR) sequences on brain magnetic resonance imaging (MRI). WMLs are most…
