The informative value of MR tomography using gadolinium-DTPA in the diagnosis of the lumbar post-discotomy syndrome

Our results have shown that MR tomography - especially if gadolinium-DTPA is used as a contrast medium - is an excellent method to differentiate between the various possible causes of the post-discotomy syndrome. In particular, it is definitely possible to differentiate between a relapsed hernia of an intervertebral dis and a postoperative development of cicatricial tissue which is practically inevitable. This differentiation is of vital importance to the clinician, because a second operation should be performed only in case of a relapse, whereas cicatricial tissue is best left alone, because no matter how carefully the operation is performed with preparation of the neural structures, even more extensive cicatricial plates are bound to develop. Instability of the vertebral column in the operated disc segment, or other causes of complaints, can be identified via MR equally well if not better than by other means. Hence, the method should be the method of choice in postdiscotomy syndrome, since it facilitates the difficult choice between conservative therapy and reoperation. (orig.)