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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6040_Библиотеки_им_академика_М_И_Перельмана.pdf
90 M. Muto et al.
Intraoperative Imaging
Fig. 2 CT axial
Postoperative Follow-Up After 10 days
Fig. 3 a-b. SE T1 and
FSE T2 sagittal. L3–L5
spondylodiscitis with
L4–L5 signal alteration,
not evident in pre-surgery
(a, b)
Case 20 - Herniated Lumbar Disk. Intradiskal Percutaneous Procedure 91
Postoperative Follow-Up After 3 Weeks
Fig. 4 a-c. SE T1 sagittal (a), STIR sagittal (b), and axial (c). Infection is worsened at L3–L5 (a, b). Infectious
tissue in L4–L5 right posterolateral and paravertebral region (c)
Herniated Lumbar Disk Percutaneous Intradiskal Procedure
Retroperitoneal Paravertebral Hematoma
Mario Muto, Gianluigi Guarnieri and Roberto Izzo
• Patient with abdominal pain following percutaneous treatment in
• Intraoperative and postoperative imaging. Early and late CT
Intraoperative Imaging
Fig. 1 CT axial during
percutaneous L4–L5
treatment with right
posterolateral approach in
prone position. Patient
suspended antiplatelet
therapy 7 days before
(with regular INR)
Case
21
diskal hernia with right posterolateral CT-guided approach
follow-up (worsening of clinical conditions)
M. Muto (&) G. Guarnieri R. Izzo
Department of Neuroradiology, ‘‘Cardarelli’’ Hospital, Naples, Italy
e-mail: mutomar@tiscali.it
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_26, Springer-Verlag Italia 2014
93
94 M. Muto et al.
Early Postoperative Follow-Up
Fig. 2 CT axial
Postoperative Follow-Up After 36 h
Fig. 3 a–d.CETC
arterious phase, axial
(a, b), coronal MPR (c),
and sagittal (d)in
abdominal pain. Large
retroperitonealparavertebral blood
collection at L1–S1 with
fluid–fluid level (a–d)
Case 21 - Herniated Lumbar Disk. Percutaneous Intradiskal Procedure 95
Subsequent Postoperative Follow-Up
Fig. 4 a-d.CETC
arterious phase, axial
(a, b), MPR sagittal (c),
and coronal (d). Blood
collection incremented in
size with signs of active
bleeding (a–d)
Herniated Lumbar Disk Anterior Diskectomy
Normal Findings
Tommaso Scarabino, Michele Maiorano, Fabio Quinto,
Michele Santoro and Raniero Mignini
• Patient with low back pain in L5–S1 herniated disk treated by
diskectomy and prosthesis positioning through anterior
approach (Anterior Lumbar Interbody Fusion, ALIF)
• Early XR postoperative follow-up
Early Postoperative Follow-Up
Fig. 1 a–b. XR antero-
posterior (a), and lateral
(b). Effects of ALIF at
L5–S1 with regular
positioning of the device
Case
22
T. Scarabino M. Maiorano F. Quinto
Department of Radiology—Neuroradiology, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
M. Santoro R. Mignini (&)
Department of Neurosurgery, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
e-mail: ranieromignini@libero.it
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_27, Springer-Verlag Italia 2014
97
Recurrent Herniated Lumbar Disk Patient Reoperated
Regular Findings
Alessandro Stecco, Francesco Fabbiano, Silvio Ciolfi,
Christian Cossandi, Piergiorgio Car, Gabriele Panzarasa
and Alessandro Carriero
Preoperative Imaging
Fig. 1 a–b. FSE T2
sagittal (a), and axial (b).
L4–L5 recurrent left
paramedian-intraforaminal
hernia that migrates
caudally, characterized by
herniated nucleus pulposus
(hydrated and T2
hyperintense); absence of
radicular conflict
Case
23
• Patient with recurrent herniated disk already treated by left L4–L5
interlaminotomy and hernia removal
• MR preoperative imaging and postoperative follow up
A. Stecco F. Fabbiano S. Ciolfi A. Carriero (&)
Department of Radiology, ‘‘Maggiore della Carità’’ University Hospital, Novara, Italy
e-mail: profcarriero@virgilio.it
C. Cossandi P. Car G. Panzarasa
Departement of Neurosurgery, ‘‘Maggiore della Carità’’ University Hospital, Novara, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_28, Springer-Verlag Italia 2014
99
100 A. Stecco et al.
Preoperative Imaging After 10 Months
Fig. 2 a–b. FSE T2 sagittal (a), and axial (b). Incremented left lateral compression on dural sac and intraforaminal
expansion
Postoperative Follow-Up
Fig. 3 a–b. FSE T2 sagittal (a), and axial (b). Herniated disk previously documented is not yet appreciable. The disk
is thinner and protrudes posteriorly in absence of L4 root conflicts. Fibrous scar adjacent to left posterolateral dural sac
without signs of disk root conflict
Recurrent Herniated Lumbar Disk Stabilization
Regular Findings
Tommaso Scarabino, Fabio Quinto, Roberto Stanzione,
Francesco Paradiso and Raniero Mignini
Preoperative Imaging
Fig. 1 a–e. SE T1 and CE
T1 (a, b), FSE T2 sagittal
(c), and CE SE T1 axial
(d–e). Left L4–L5
persisting hernia and
surrounding fibrous scar
Case
24
• Patient with recurrent herniated disk already treated by discectomy
and positioning of L4–L5 interbody prosthesis trough anterior
approach (Anterior Lumbar Interbody Fusion, ALIF)
• Preoperative imaging and early/late XR postoperative follow-up
T. Scarabino (&) F. Quinto R. Stanzione
Department of Radiology—Neuroradiology, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
e-mail: tscarabino@hotmail.com
F. Paradiso R. Mignini
Department of Neurosurgery, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_29, Springer-Verlag Italia 2014
101
102 T. Scarabino et al.
Fig. 1 (continued)
Preoperative Follow-Up
Fig. 2 a–b. XR pre-surgery anteroposterior (a), lateral (b). Slight reduction of D11, D12 and L1 height