Magnetic resonance imaging findings of disc-related epidural cysts in nonsurgical and postoperative microdiscectomy patients
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2012-06-01
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Objective: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. Materials and Methods: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. Results: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. Conclusion: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified. © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem.
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Simão, MN, CA Helms and WJ Richardson (2012). Magnetic resonance imaging findings of disc-related epidural cysts in nonsurgical and postoperative microdiscectomy patients. Radiologia Brasileira, 45(4). pp. 205–209. 10.1590/S0100-39842012000400005 Retrieved from https://hdl.handle.net/10161/31408.
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William James Richardson
- Current research includes investigation of biomechanical aspects of cervical injury with head impact. This involves cadaveric work with high-speed photography and load cells to ascertain the mechanism for spinal fractures.
2. An animal model is being used to evaluate the biomechanics of cervical laminectomy versus laminoplasty compared to the normal spine. A portion of the animals are developing myelopathy secondary to instability after the surgical procedure and this is being evaluated with MRI scanning as well as mechanical and radiographic testing.
3. Studies are being performed to develop an impedance pedicle probe to aid safe insertion of pedicular instrumentation in the lumbar spine. Ongoing studies are being performed to define the optimal frequency for the probe to yield the most sensitive and specific device. Hopefully this will lead to development of a device for human use. Studies will compare impedance probe to currently used EMG techniques to see if combing them will lead to greater sensitivity and specificity.
4. Studies are being completed on testing particular pull-out strength and doing a multi-varied analysis looking at size of the pedicle and bone density by two different techniques.
5. Current work is ongoing to develop an outcomes instrument and database to be used in the outpatient setting for patients with spinal complaints, both cervical and lumbar. The device will be used to evaluate clinical effectiveness for a variety of treatments for spinal conditions and to look at patient satisfaction issues.
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