ArticleSkeletal radiology2020
Differentiating epidural fibrosis from disc herniation on contrast-enhanced and unenhanced MRI in the postoperative lumbar spine.
Article in Skeletal radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Interpreting acute postoperative MRI after lumbar spinal fusion: a practical framework for clinical decision-making.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Bispecific antibody engineered extracellular vesicles redirect T cells to prevent postoperative epidural fibrosis.Nature communications · 2026Article
- Imaging persistent spinal pain syndrome and spine surgery complications: an interpretation guide for radiologists.Insights into imaging · 2026Article
- The dose-dependent effect of tranexamic acid on epidural fibrosis after laminectomy: an experimental study on rats.Acta orthopaedica et traumatologica turcica · 2025Article
- Spondylodiscitis and Its Mimickers: A Pictorial Review.Biomedicines · 2024Review
- A Comparative Study of Endoscopic versus Percutaneous Epidural Neuroplasty in Lower Back Pain: Outcomes at Six-Month Follow Up.Medicina (Kaunas, Lithuania) · 2024Article
- Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents.Insights into imaging · 2024Review
- Continuous release of mefloquine featured in electrospun fiber membranes alleviates epidural fibrosis and aids in sensory neurological function after lumbar laminectomy.Materials today. Bio · 2022Article
- Case Report: Nerve Root Entrapment Due to Epidural Fibrosis in a Patient With Failed Back Surgery Syndrome: Value of 2-Frontiers in medicine · 2022Article
- Prognosis Evaluation of MRI Combined with Magnetic Resonance Myelography on Lumbar Disc Herniation after Transforaminal Endoscopic Discectomy.Computational and mathematical methods in medicine · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine diagnostic confidence and inter-observer/intra-observer agreement in differentiating epidural fibrosis from disc herniation and lumbar spinal stenosis parameters on magnetic resonance images (MRI) in postoperative lumbar spines with (Gad-MRI) and without (unenhanced MRI) intravenous gadolinium-based contrast agent. SUBJECTS AND
methodsN = 124 lumbar spine MRI examinations of four groups were included: 1-6 months, 7-18 months, 19-36 months, more than 37 months between lumbar spine surgery and imaging. Two radiologists evaluated Gad-MRI and unenhanced MRI: diagnostic confidence was determined as confident or unconfident. Inter-observer and intra-observer agreement were assessed in differentiating epidural fibrosis from disc herniation and for lumbar spinal stenosis parameters on MRI. Fisher's exact test and Cohen's kappa served for statistics.
resultsDiagnostic confidence in differentiating epidural fibrosis from disc herniation was significantly higher on Gad-MR images compared with unenhanced MRI at 1-18 months for observer 1 and at 1-6 months postoperatively for observer 2 (p values: 0.01-0.025). Inter-observer agreement at 1-6 months postoperatively for identification of epidural fibrosis was higher on Gad-MRI (kappa values: 0.53 versus 0.24). Inter-observer and intra-observer agreement for identification of disc herniation and for assessment of lumbar spinal stenosis parameters revealed inconsistent data, without a trend for higher inter-observer or intra-observer agreement on Gad-MRI compared with unenhanced MRI (kappa values: 0.17-0.75).
conclusionGad-MR images compared with unenhanced MRI improved diagnostic confidence and agreement in differentiating epidural fibrosis from disc herniation for both observers in the first 6 months and for one observer in the first 18 months after lumbar spine surgery. After 18 months, Gad-MR images compared with unenhanced MRI did neither improve confidence nor agreement.
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