Some patients get MRI studies during the immediate period following a non-traumatic back procedure. Once performed, these MRI have the potential to confuse the entire clinical picture rather than to shed light about the healing process.
Many authors in the country and internationally have published important scientific papers about the characteristics of MRI changes in the postoperative of asymptomatic (no complaints) patients who had a successful lumbar disc operation. They found that there was no good correlation between symptoms and MRI images during that period. The MRI showed changes that mimic (look-like) the pre-surgical images; however, the patients were doing very well from the clinical standpoint. These MRI changes could sometimes persist for up to a year.
Scott Boden, MD published an article in Radiology, 1992, where he states that in the postoperative, the normal and typically expected enhancement pattern: “was indistinguishable from that seen with a recurrent (re-appearance) or a residual (the herniation was not taken out completely) disk fragment surrounded by scar or inflammatory tissue” and continues: “Decisions about surgery made on the basis of MR studies obtained during the first 3 to 6 months postoperatively must be carefully considered”.
Andrew Deutsch, MD (Spine 1993) performs MRI studies in 23 asymptomatic patients 1 year after successful lumbar disc operations. He found that 50 % of the patients showed posterior disc problems that mimicked the original herniated disc problem. He went on to describe 15% of cases in which no change or an even greater disc problem was shown in the MRI after a year of successful disc operation.
Even though these studies were performed in patients that did not have (or had minimal) symptoms, I wouldn’t like to give the false impression that post-surgical MRI studies are useless. Under special circumstances, they could add valuable information when ordered at the proper time. In conjunction with the clinical picture and an in-depth analysis of the actual films, these radiological studies could help the surgeon determine what is the best course of action for one’s particular case during the postoperative recovery.