Approach to interpret images produced by new generations of multidetector CT scanners in post-operative spine

• Published in: British journal of radiology 2017-11, Vol.90 (1079), p.20170082-20170082
• Main Authors: Zeitoun, Rania, Hussein, Manar
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bone Plates - adverse effects; Bone Screws - adverse effects; Child; Child, Preschool; Diagnostic Radiology; Female; Humans; Male; Middle Aged; Multidetector Computed Tomography - instrumentation; Multidetector Computed Tomography - methods; Pain, Postoperative; Postoperative Period; RADIODIAGNOSIS - Central nervous system; RADIODIAGNOSIS - Skeletal; RADIODIAGNOSIS - Techniques/Subspecialties; Retrospective Studies; Spinal Fusion - instrumentation; Spine - diagnostic imaging; Spondylosis - diagnostic imaging; Treatment Failure
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20170082

To reach a practical approach to interpret MDCT findings in post-operative spine cases and to change the false belief of CT failure in the setting of instruments secondary to related artefacts. We performed observational retrospective analysis of premier, early and late MDCT scans in 68 post-operative spine patients, with emphasis on instruments related complications and osseous fusion status. We used a grading system for assessment of osseous fusion in 35 patients and we further analysed the findings in failure of fusion, grade (D). We observed a variety of instruments related complications (mostly screws medially penetrating the pedicle) and osseous fusion status in late scans. We graded 11 interbody and 14 posterolateral levels as osseous fusion failure, showing additional instruments related complications, end plates erosive changes, adjacent segments spondylosis and malalignment. Modern MDCT scanners provide high quality images and are strongly recommended in assessment of the instruments and status of osseous fusion. In post-operative imaging of the spine, it is essential to be aware for what you are looking for, in relevance to the date of surgery. Advances in knowledge: Modern MDCT scanners allow assessment of instruments position and integrity and osseous fusion status in post-operative spine. We propose a helpful algorithm to simplify interpreting post-operative spine imaging.