Imaging Spine After Treatment: A Case-based Atlas

279 Pages·2014·14.29 MB·English

by  Saverio Pollice

Tommaso Scarabino
Saverio Pollice
Editors
Imaging Spine
After Treatment
A Case-based Atlas
Foreword by
Carlo Faletti
Imaging Spine After Treatment
Tommaso Scarabino
Saverio Pollice
Editors
Imaging Spine After
Treatment
A Case-based Atlas
Foreword by Carlo Faletti
In collaboration with Paola D’Aprile, Mario Muto,
Alessandro Carriero, Alessandro Stecco, Ferdinando
Caranci, Gabriele Polonara, Giuseppe Guglielmi,
Teresa Popolizio, Armando Tartaro, Luigi Manfre`,
Raniero Mignini
123
Tommaso Scarabino
Saverio Pollice
Department of Radiology—Neuroradiology
‘‘L.Bonomo’’ Hospital
Andria, BT
Italy
ISBN 978-88-470-5390-8 ISBN 978-88-470-5391-5 (eBook)
DOI 10.1007/978-88-470-5391-5
SpringerMilanHeidelbergNewYorkDordrechtLondon
LibraryofCongressControlNumber:2013939042
(cid:2)Springer-VerlagItalia2014
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Foreword
Imaging of the spine represents since many years a fundamental step in
the identification of the disease and then in the following treatment
planning.
Treatment is influenced by proposed and executed diagnostic work
up,bothintermsofuseddiagnostictechniquesthatusesqualitativeand
iconographic interpretation.
The first point is the virtuous plot between quality of examinations
and diagnostic result, is definitely under the responsibility of the radi-
ologist dedicated to the pathology of the spine and moreover must be
linked appropriately and professionally impeccable.
The second point is related to the professional preparation that,
although integrated by experience, can not be separated from a thor-
ough clinical andtechnological knowledge,constantly updatedthrough
professional training.
This definition becomes essential when you have to study the ‘‘diffi-
cult’’fieldofpost-surgicalimaging,where,inadditiontotheknowledge
of surgical techniques and their results, there is the uneasy task of
expressing an opinion with high diagnostic value in the medical-legal
branch.
A text that takes into account these important factors must become
anintegralpartofculturalbackgroundindiagnosticimagingespecially
for radiologists dedicated to the study of the pathology of the spine.
This volume examines, in a comprehensive way, the normal and
pathological features that may arise in diagnostic imaging in the oper-
atedspine,byspecifyingtheroleofthevariousimagingtechniques,their
use, the ‘‘prickly’’ boundary between normal and pathological and then
the different pathological findings.
A praise to the authors and especially to Tommaso Scarabino for
being able to pick up an important case study collection, clearly and
comprehensive structured, easy to read and reference.
This text, therefore, must be present on the desk for frequent use.
v
vi Foreword
Myinvitationcanonlybeso toacquire anduse thistext,toincrease
diagnostic performance towards colleagues but particularly for the
benefits of patients.
Turin, 2013 Carlo Faletti
Radiodiagnostica CTO
Azienda Ospedaliera Citta` della Salute e della Scienza di Torino
Turin, Italy
Preface
Thispaperprovidesareviewaboutimagingassessmentofthespineafter
treatment. This discussion is preceded by a detailed examination of
spinaldisorders(majorcauseofsurgeryand/orinterventionalradiology)
and its various types of treatments used indaily clinical practice.
In general, any surgical approach alters the normal anatomical and
functional arrangement of the district which is aimed, therefore image
interpretation cannot ignore a correct set of knowledge in the field of
anatomy, pathophysiology, drug compliance, interventional radiology,
surgery.
Neuroradiological imaging plays an important role in the post-oper-
ativeevaluationofpatientsundergoingspinalsurgery.Inparticular,itis
essential in documenting normal and pathological post-treatment
changes,specifictoapproachtype;indetectinganycomplicationsandin
the follow-up.
Imaging assessment of spine after surgery is complex and depends
upon several factors including: surgical procedures and disease for
which it was performed; biomechanical of the underlying cortical and
cancellous bone; conditions of muscles, intervertebral disc and liga-
ments; time since surgery procedures; duration and nature of the post-
surgicalsyndrome.Dependinguponthesefactors,oneoracombination
of complementary imaging modalities (XR, CT, MR) may be required
to evaluate effectiveness of the treatment; to demonstrate any clinically
relevant abnormality at the treated region and adjacent structures; to
assist the interventional radiologist or surgeon in deciding if it is nec-
essary intervene again, in which nature and in which vertebral level(s).
Tommaso Scarabino
vii
Acknowledgments
The topic of this volume is the neuroradiological imaging of spinal
pathology after surgery or interventional radiology treatment. Normal
and pathological findings (including complications) in X-ray, CT and
MRI will be evaluated.
Thisbookispresentedasatext-atlas.Thefirstpart(text)isessential
andsyntheticandtalksaboutspinaldiseasessubjectedtointerventional
procedure and/or surgery with its specific and various types of
approach. Afterwards radiological and neuroradiological diagnostic
techniques in post-treatment are assessed. The second part (atlas)
instead includes a large iconography as the result of multicentre col-
laboration with top experts in this matter to which I express my grati-
tude.Withouttheiressentialcollaborationwouldnothavebeenpossible
to carry out the work!
FinallyasincerethankstothepublishinghouseSpringerVerlagItaly
and in particular to Ms. Cerri, for the enthusiasm with which she
receivedthisscientificinitiative,andtothewholeteamforthegreatcare
and professionalism shown in the drafting of the publication.
Tommaso Scarabino
ix
Contents
Part I
1 Pathology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Saverio Pollice, Pietro Maggi, Tullia Garribba,
Saverio Lorusso and Tommaso Scarabino
2 Interventional Radiology. . . . . . . . . . . . . . . . . . . . . . . . . . 9
Tommaso Scarabino, Fabio Quinto, Carmine Iaffaldano,
Michele Santoro and Raniero Mignini
3 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Tommaso Scarabino, Vincenzo Brandini, Michele Santoro
and Raniero Mignini
4 Imaging Modalities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Saverio Pollice, Michele Maiorano, Angela Lorusso,
Francesco Nemore and Tommaso Scarabino
5 Post-treatment Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Saverio Pollice, Michela Capuano, Roberto Stanzione,
Marianna Schiavariello and Tommaso Scarabino
Part II Clinical Cases
6 Case 1: Herniated Lumbar Disk. Diskectomy. Aseptic
Spondylodiscitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Paola D’Aprile and Alfredo Tarantino
7 Case 2: Herniated Lumbar Disk. Diskectomy.
Aseptic Spondilodyscitis . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Paola D’Aprile and Alfredo Tarantino
8 Case 3: Herniated Lumbar Disk. Diskectomy. Scars
Sequelae. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Mario Muto, Gianluigi Guarnieri and Roberto Izzo
xi
xii Contents
9 Case 4: Herniated Lumbar Disk. Diskectomy.
Scars Sequelae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Simone Salice, Domenico Tortora, Valentina Panara,
Massimo Caulo and Armando Tartaro
10 Case 5: Herniated Lumbar Disk. Diskectomy.
Pathological Postoperative Scar . . . . . . . . . . . . . . . . . . . . 49
Paola D’Aprile and Alfredo Tarantino
11 Case 6: Herniated Lumbar Disk. Diskectomy.
Pathological Postoperative Scar . . . . . . . . . . . . . . . . . . . . 51
Paola D’Aprile and Alfredo Tarantino
12 Case 7: Herniated Lumbar Disk. Diskectomy.
Pathological Postoperative Scar . . . . . . . . . . . . . . . . . . . . 53
Ferdinando Caranci, Anna Caliendo, Carmen Castagnolo,
Raffaele Nappi and Achille Marotta
13 Case 8: Herniated Lumbar Disk. Diskectomy.
Recurrence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Paola D’Aprile and Alfredo Tarantino
14 Case 9: Herniated Lumbar Disk. Diskectomy.
Recurrence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Paola D’Aprile and Alfredo Tarantino
15 Case 10: Herniated Lumbar Disk. Diskectomy.
Recurrent Hernia and Coexisting Fibrous Scar. . . . . . . . . 63
Simone Salice, Domenico Tortora, Valentina Panara,
Massimo Caulo and Armando Tartaro
16 Case 11: Herniated Lumbar Disk. Diskectomy.
Recurrence and Fibrous Scar . . . . . . . . . . . . . . . . . . . . . . 65
Paola D’Aprile and Alfredo Tarantino
17 Case 12: Herniated Lumbar Disk. Micro-Diskectomy.
Aseptic Radiculitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Paola D’Aprile and Alfredo Tarantino
18 Case 13: Herniated Lumbar Disk. Diskectomy.
Septic Spondylodiscitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Paola D’Aprile and Alfredo Tarantino
19 Case 14: Herniated Lumbar Disk. Diskectomy.
Septic Spondylodiscitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Paola D’Aprile and Alfredo Tarantino