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G Simonetti

Publications and source records attributed to G Simonetti.

At least 55 records · Page 3Linked to original sources
PubMed2000

Propyl gallate increases in vitro antifungal imidazole activity against Candida albicans.

We looked at the in vitro effect of an antioxidant, propyl gallate (PG), on the antifungal activity of miconazole sulphosalicylate, econazole sulphosalicylate and ketoconazole against 40 clinical isolates of Candida albicans. The combination of imidazole and PG gave MIC values 10-150 times lower than those of imidazole alone. The optimal conditions for this enhanced activity were pH 6.2-8.0 and a fungal cell concentration lower than 3 x 10(5) cells/ml. The mechanism of the interaction between imidazole and PG is not known but may be as a result of an effect of PG on the P-450 cytochrome. Theoretically this combination could reduce the side effects of long treatment with imidazoles and lower the risk of resistance to these antifungal drugs.

Antifungal Agents↗
PubMed2000

Morphologic grading of emphysema is useful in the selection of candidates for unilateral or bilateral reduction pneumoplasty.

OBJECTIVE: Radiologic morphology of emphysema proves useful in the selection of candidates for bilateral reduction pneumoplasty. We developed a simple morphologic grading system capable of identifying subsets of patients who had maximal functional improvement after unilateral or bilateral operation. METHODS: Fifty-two patients who underwent unilateral (n=34) or bilateral (n=18) reduction pneumoplasty were evaluated. Emphysema morphology was visually scored by digital roentgenograms and high-resolution computed tomography. In each lung, severity of emphysema (ES), heterogeneity (DHT) and hyperinflation (DHF) degrees, were assessed. Asymmetric ratio of emphysema (ARE) between the lungs was expressed as: higher ES/lower ES scores. Morphometric data were correlated with absolute preoperative-postoperative FEV(1) change (DeltaFEV(1)). RESULTS: No difference was found between the unilateral and the bilateral group for ES and DHT. DHF was greater in the bilateral group (3.1 vs. 2.7, P=0.02) whereas ARE was greater in the unilateral group (1.29 vs. 1. 05, P=0.0001). Stepwise logistic regression extracted as best predictors of maximal DeltaFEV(1), ARE (odds ratio=238, Wald test P=0.04) in the unilateral group, and DHT (odds ratio=24, P=0.03) in the bilateral group. Unilateral group DeltaFEV(1) was greater in patients with ARE>/=1.3 (0.44 vs. 0.24 l, P=0.02). Bilateral group DeltaFEV(1) was greater in patients with DHT>1 (0.50 vs. 0.31 l, P=0. 03). No difference was found when comparing DeltaFEV(1) resulting from unilateral RP and ARE>/=1.3, and bilateral RP (0.44 vs. 0.41 l, not significant). CONCLUSIONS: This morphologic grading system identified subsets of patients who had maximal functional benefit from unilateral or bilateral reduction pneumoplasty and might be useful in the preoperative screening of candidates for either approach.

Adult↗
PubMed2000

Late symptomatic venous stenosis in three hemodialysis patients without previous central venous catheters.

It is well known that catheters placed in the subclavian or internal jugular veins may develop stenosis in the vein in which the catheter lies. Because the arteriovenous fistula (AVF) relies on good venous outflow, patients with ipsilateral central venous stenosis are subject to the malfunctioning of AVF. Until now, no data were published on patients showing central vein stenosis (CVS) without a previous central venous catheter (CVC) or a pacemaker. In this article, we report on 3 hemodialysis patients manifesting CVS ipslateral to AVF. None of these patients previously had undergone CVC. The stenosis observed had characteristics and symptoms similar to those observed in stenoses consequent to CVC. We concluded that CVS also may occur in subclavian or axillary veins proximal to a working AVF in hemodialysis patients who have never had a CVC and in the absence of compressive phenomena.

Adult↗
PubMed2000

Anticandidal activity of SPA-S-843, a new polyenic drug.

The activity of a new, soluble and stable polyene (SPA-S-843) against Candida albicans was assessed by contact and culture tests and by inhibition of germ-tube formation. The drug demonstrated a higher contact activity and lower MICs than amphotericin B. This antimicrobial activity was more evident under acid pH and low ionic strength. In addition, the ability of SPA-S-843 to inhibit Candida sp. conversion from yeast to mycelial form was evident at low drug concentrations (0.25-0.62 mg/L).

Amphotericin B↗
PubMed1999

Percutaneous ilio-caval thrombectomy with the Amplatz device: preliminary results.

The Amplatz Thrombectomy Device (ATD) is a percutaneous, rotational thrombectomy catheter, capable of recirculating and homogenizing the thrombus in order to obtain mechanical clot dissolution. The authors present their experience with mechanical thrombectomy with the ATD in eight cases of ilio-caval thrombosis. Under temporary caval filter protection, the ATD was introduced through the right transjugular approach (in one patient this was used in combination with the right femoral approach) and activated for a time ranging from 90 to 180 s. Complete clearing of thrombotic material in the treated venous segments was achieved in six cases (75 %), partial success was obtained in one case (12.5 %) and failure occurred in one patient (12.5 %). One patient developed a recurrence of venous iliac thrombosis 1 week after the procedure and postphlebitic syndrome 6 months after the first episode of deep venous thrombosis, and one patient died from acute myocardial infarction, unrelated to thrombectomy session, after 3 days. A negative clinical and radiological follow-up at 3, 6, 12 and 24 months was obtained in the remaining six patients. If a fresh free-floating ilio-caval clot must be removed immediately, the ATD can be effective under temporary filter protection.

Adult↗
PubMed1999

Thoracoscopic reduction pneumoplasty for severe emphysema: do pleural adhesions affect outcome?

BACKGROUND: Pleural adhesions are frequently encountered in patients undergoing reduction pneumoplasty. We evaluated the impact that pleural adhesions had on the surgical technique and outcome of thoracoscopic reduction pneumoplasty. METHODS: 59 operated patients were divided into 2 groups depending on the presence (group A) or absence (group B) of pleural adhesions. RESULTS: At inter-group comparison (A versus B) a significant difference was found for mean duration of operation (128+/-55 min versus 73+/-33 min; p<0.005), morbidity (14 versus 9 patients; p<0.05), and hospital stay (14.1+/-11.8 days versus 12.0+/-7.4 days; p<0.001). Complications occurred less frequently in the last 29 patients than in the first 30 patients (11 versus 24; p<0.03). At histopathologic analysis subpleural (p<0.005) and interstitial fibrosis (p<0.001), and interstitial granulomas (p<0.012) were more frequent in group A specimens. At six months dyspnea index, six-minute-walk test, FEV1, FVC, PaO2, and prednisone and oxygen independence improved significantly in both groups. However FEV1 increased less in group A (1.20+/-0.2L vs 1.31+/-0.3L; p < 0.01). CONCLUSIONS: Pleural adhesions may be associated with increased morbidity and less improvement in FEV1 but they do not contraindicate thoracoscopic reduction pneumoplasty.

Aged↗
PubMed1999

[Angiography with spiral computerized tomography in the study of aneurysms of the visceral arteries. Techniques and results].

INTRODUCTION: The aneurysms of visceral vessels are characterized by few or no symptoms and the diagnosis is often occasional. We investigated the usefulness of CT angiography in the diagnosis and preoperative assessment of this condition. MATERIALS AND METHODS: From January 1993 to March 1998, twenty-five patients (aged 32-69 years) with 28 aneurysms underwent CT angiography before and after contrast agent injection to study lesion number, site, size, neck, intraluminal thrombosis and wall calcifications. Data from axial images were postprocessed on an external work-station to obtain CT angiograms. CT angiography findings were analyzed with a double blinded method by 2 radiologists comparing CT angiography with digital subtraction angiography images and evaluating the information obtained from Multiplanar (MPR), Maximum Intensity Projection (MIP) and Shaded Surface Display (SSD) reconstructions. Surgical findings were available for 10 patients. RESULTS: There was complete agreement between CT angiography and digital subtraction angiography in the identification of all lesions; the correlation rate was 94.42% for lesion location, 89.28% for lesion size, 85.71% for detection of endoluminal thrombosis and 82.14% for identification of wall calcifications. Axial and MPR images were useful in the assessment of ali parameters, while MIP images accurately demonstrated wall calcifications and the lesion relationships with adjacent structures. No additional information was obtained from SSD reconstructions. CONCLUSIONS: In our experience CT angiography can replace digital subtraction angiography in the diagnosis and preoperative work-up of visceral vessels aneurysms. CT angiography was superior to digital angiography in the evaluation of the lesion exact dimensions in cases with large thrombotic component and diffuse wall calcifications.

Adult↗
PubMed1999

[The clinical efficacy of magnetic resonance with diffusion-weighted sequences in the assessment of acute cerebral ischemia].

PURPOSE: To evaluate the efficacy of diffusion weighted Magnetic Resonance Imaging in the diagnosis of acute ischemic infarction and correlate the signal changes observed in the acute phase with final brain damage. MATERIAL AND METHODS: Fifteen patients (six women and nine men: mean age 68 years) with acute ischemic stroke (within 12 hours) underwent diffusion MRI. All the patients were selected on the basis of sudden focal neurologic symptoms and CT findings excluding other conditions than ischemia. MRI was performed with a 1.5 T magnet with echo-planar gradients. All the patients underwent follow-up CT and/or MRI. RESULTS: Diffusion MRI, performed in the acute phase, showed signal changes in all the patients whose infarction was later confirmed by CT or MRI. In 10 of 12 patients with positive diffusion imaging, CT was normal. FLAIR sequences showed the lesions in 4 of 12 cases. In the 2 patients with transient ischemic attack diffusion MRI was normal as well as follow-up examinations. Apparent Diffusion Coefficients values in the infarcted area were almost half those of the contralateral normal brain. Final damage (as assessed by CT or MRI) was larger than observed in acute diffusion images in all cases but one. CONCLUSION: Because of its high sensitivity and specificity, diffusion MRI is going to play a more important role in the management of acute ischemic stroke patients.

Acute Disease↗
PubMed1999

[Breath-hold gadolinium enhanced tree-dimensional MR angiography: personal experience in the thoracic-abdominal area].

PURPOSE: To investigate different clinical applications of gadolinium-enhanced MR angiography (Gd MRA) using three-dimensional breath-hold GE sequences, without bolus time calculation, in patients with vascular diseases. MATERIAL AND METHODS: Forty-seven patients were examined (49 studies in all). Eleven of them had an abdominal aortic aneurysm, 6 surgical bypass, 7 renal artery stenosis, 3 aortoiliac Wallstent, 7 aortic stent-graft; 11 patients had a suspected condition in the thoracic aorta and pulmonary arteries, 1 had subclavian artery stenosis and 1 suspected axillary artery compression. All patients were submitted to breath-hold Gd MRA, after 30-40 mL Gd, with a 1.5 T magnet (Gyroscan ACS-NT, Philips, The Netherlands) and a standard body coil. The GE sequences were acquired with TR = 8.8, TE = 2.7, FA = 60 degrees, matrix = 163 x 512, with 28 seconds acquisition time. Digital subtraction angiography and intraoperative findings were the reference standards to evaluate the results. RESULTS: Thoracopulmonary district: metastatic compression of axillary vessels was found in 1 breast cancer patient; the true and the false lumens and the intimal flap were identified in 2 patients with chronic aortic dissection (Stanford A), and graft patency and complete resolution of the aortic dissection was seen in the patient operated on for acute aortic dissection (Stanford A). The thrombus, lumen, extent and diameter were studied in 2 patients with thoracic aortic aneurysms. Subclavian artery stenosis was demonstrated in 1 patient, which was treated with transluminal angioplasty and stenting. The other 6 patients had normal findings. Abdominal aortic aneurysms (AAA): as for disease extent, breath-hold Gd MRA had 100% sensitivity and specificity compared with surgical findings. Juxtarenal aneurysm extent, which had been missed at DSA, was detected in 1 patient and then confirmed at surgery. Stenosis: comparing DSA and MRA findings in the whole series of patients we had 97.4% agreement (155/159 arteries), that is 76.4% (13/17) arteries) considering only stenoses > 50%. Breath-hold Gd MRA sensitivity and specificity were 100 and 87.5%, respectively, in our 28 stenoses. Bypass, aortoiliac stent, vascular endograft: patency was demonstrated in all the 6 surgical bypass patients, and there was agreement with color Doppler findings in 5 of 6. Breath-hold Gd MRA seems to have no possible applications in the follow-up of percutaneously implanted iliac stents, but we had excellent findings about patency and position of nichel-titanium endografts used for AAA treatment. CONCLUSIONS: We optimized breath-hold 3D MRA without bolus transit time calculation and with high-dose Gd in different clinical vascular conditions. In our opinion, 3D GE sequences can replace DSA in selected cases, providing a fast, accurate and noninvasive examination.

Abdomen↗
PubMed1998

Trans-sphenoidal treatment of postsurgical cerebrospinal fluid fistula: CT-guided closure.

Cerebrospinal fluid (CSF) leakage after trans-sphenoidal surgery is a troublesome complication with a risk of meningitis and pneumocephalus. We suggest CT-guided intrasphenoidal injection of fibrin sealant through a 12-gauge needle as a simple alternative to surgical management of CSF fistulae. We treated eight patients, operated via the trans-sphenoidal route (five pituitary adenomas, three craniopharyngiomas), for a postoperative CSF leak by CT-guided intrasphenoidal injection of fibrin sealant alone in three cases and fibrin sealant and autologous blood in 5. CT was obtained 10 days after the procedure in all cases. In four patients, the CSF leak was closed successfully at the first attempt. The procedure was repeated on the four remaining patients because only a reduction in leakage was obtained at the first attempt. This procedure preserves olfaction and avoids the risk of frontal lobe damage. It could therefore represent the treatment of choice in many cases of anterior cranial fossa postsurgical CSF leaks.

Adult↗
PubMed1998

Non-invasive assessment of neck-vessel pathology.

Clinical trials (NASCET, ECTS) have shown that carotid endarterectomy is protective against stroke in patients with symptomatic severe carotid stenosis. To decrease costs and risks, new diagnostic tools have been developed, such as duplex ultrasound (DUS), magnetic resonance angiography (MRA), and more recently computed tomography angiography (CTA). CTA and MRA provide excellent 3D angiography images of the extracranial vessels, using a volume-rendering technique. Digitally subtracted MRA (DSA-MRA) obtained with high-speed acquisitions during gadolinium injection has also recently become available. These techniques are changing the role of non-invasive assessment of carotid stenosis. Although it is probably too early to assess a definite diagnostic algorithm, the use of DSA as a pre-surgical tool for defining carotid stenosis is rapidly decreasing.

Angiography, Digital Subtraction↗
PubMed1998

What's new in mammography.

Early diagnosis of breast cancer plays the leading role in reducing mortality rates and improving the patients' prognosis: mammography is the most sensitive technique currently available for the detection of nonpalpable lesions and therefore the method of choice. However, mammography has some limitations and the technique must be improved with technological devices without affecting image quality. This could be the target to increase diagnostic accuracy. Mammography sensitivity and specificity are now improved with the digital computer assisted technique, teleradiology, digital tomosynthesis or digital angiography--used to study microvascularization--3D imaging or synchrotron light, and laser mammography. Such other technological devices as Mammospot reduce breast thickness and provide better breast compression. Digital mammography can be carried out with film or direct digitization. The advantages of the digital technique are a shorter examination time, less storage space, electronic image recording, with image 'adjustments' made by the radiologist, and especially computerized analysis. The computer aided diagnosis can be defined as the diagnosis made by the radiologist who considers the results of computerized analysis as a 'second opinion'. In this way incidental mistakes made by radiologists, can be corrected by the computer analysis. Computers are a basic element also in teleradiology, which needs immediate and simultaneous admittance to the patient's history and permits radiology optimization in rural areas too. As for tomosynthesis, it permits to study a single slice of the breast without glandular tissue overlapping, which is useful in dense breasts where the diagnosis can be made with a lower X-ray dose. Moreover, this method fits the current mammographic systems easily. 3D imaging is still a work in progress. Synchrotron mammography is used only on surgery specimens, where it exhibits high resolution and contrast, depicting structures and details missed by conventional mammography. Breast DSA allows the study of vessels < 0.20 mm in diameter and of fine microvascular details; it can also demonstrate neoangiogenesis. Laser mammography permits bilateral examinations of the breast in 10-15 mins and is currently used also for breast cancer therapy, although only in animal trials. To conclude, after reviewing new techniques and evaluating the real cost/benefit ratio for each of them, conventional mammography remains the most sensitive tool for breast cancer diagnosis.

Angiography, Digital Subtraction↗
PubMed1998

Unilateral thoracoscopic reduction pneumoplasty for asymmetric emphysema.

OBJECTIVE: We prospectively analyzed the surgical and functional results of unilateral thoracoscopic reduction pneumoplasty which we performed by choice in patients with asymmetric emphysema. METHODS: Between October 1995 and June 1997, 119 emphysematous patients were examined and 34 were operated upon. Among these, 14 selected patients with asymmetric distribution of emphysema in the lungs underwent unilateral reduction pneumoplasty (ten right, and four left). There were 13 males and one female, with a mean age of 62 years. Eligibility criteria included bullous and non-bullous end-stage emphysema with severe limitation to daily activity. RESULTS: No patient required conversion to thoracotomy. Mean operative time ranged between 70 and 240 min with a mean of 103 min. There was no postoperative mortality but five patients developed one or more complications: five prolonged air leaks (>7 days); two pulmonary infections; one empyema. No patient required postoperative mechanical ventilation. Median hospital stay was 8 days. At the 3-month follow-up the mean FEV1 increased from 0.8 l to 1.2 l (P < 0.001). Mean FVC increased from 2.6 l to 2.9 l (P < 0.001). The Medical Research Council dyspnea score decreased from a mean of 3.2 to 1.8 (P < 0.001). CONCLUSIONS: Asymmetric distribution is a frequent finding in patients with severe emphysema. Unilateral thoracoscopic reduction pneumoplasty may represent an ideal approach in this selected group of patients.

Aged↗
PubMed1998

[Role of diagnostic imaging in the assessment of lung complications of burns].

PURPOSE: We investigated the frequency of pulmonary complications in burn patients and the clinical and prognostic role of chest radiography and CT patterns in these patients. MATERIAL AND METHODS: We examined 203 patients with first- to third-degree burns involving up to 90% of the body surface; the patients were 119 men and 84 women ranging in age 1 to 96 years (mean: 30). Burns on the face, sooth in the sputum and fire in an unventilated area indicated smoke inhalation in three patients. All patients were submitted to bedside chest radiography on hospitalization and the examination was repeated during the hospital stay in 26 patients. Seven patients with pulmonary complications also underwent chest CT. Five patients with severe, extensive burns (> 70% of the body surface) and with no clinical signs of respiratory complications were submitted to HRCT within 48 hours of admission. RESULTS: Lung complications developed in 16 patients (7.8%), leading to clinical and radiographic signs of adult respiratory distress syndrome (ARDS) in 11 of them (5.4%), namely 5 women and 6 men (age range: 19-96 years, mean: 50). Only one of the three patients with smoke inhalation developed ARDS. The extension of burn injuries ranged 18-86% of the body surface. ARDS developed within 12 hours-14 days of injury (mean: 8 days). Four patients (36%) had right lung involvement alone, two (18%) had bilateral, mostly right-lobe, abnormalities, and five patients (46%) had frankly bilateral findings; the latter were associated with pleural effusions in the left lower lobe in one patient. Compared with chest radiography, HRCT always identified the initial signs of interstitial edema and subpleural emphysematous bullae were detected in a patient who subsequently exhibited clinical and radiographic signs of ARDS. Nine (82%) of the 11 ARDS patients died of respiratory insufficiency. Most deaths (6 patients, 67%) occurred within a few hours of the onset of distress; in three patients with unilateral pulmonary edema death occurred within 6, 7 and 8 days, respectively. ARDS patients had significantly larger body surface areas burned and higher incidence of third-degree burns. DISCUSSION: The incidence of radiologically confirmed pneumonia was 1%; the causative pathogens were Pseudomonas aeruginosa and Staphylococcus aureus. HRCT detected a pneumatocele in a patient with Staphylococcus pneumonia. One patient had eosinophilic pleurisy and another a pulmonary microembolization. The overall mortality in our patients with burns and pulmonary complications was 56% versus 2% in the rest of the series, which confirms the importance of an early diagnosis to optimize treatment planning in such cases. For these reasons CT, and particularly HRCT, studies can be best because these techniques can show even minimal parenchymal changes. These examinations will be increasingly feasible also in critically ill and barely movable patients thanks to the latest mobile CT units which permit scanning also in intensive and subintensive care units.

Adolescent↗
PubMed1998

[An evaluation of the carotid bifurcation and of the intracranial circle by angio-spiral computed tomography].

INTRODUCTION: Some clinical trials (NASCET, ECTS) have assessed that carotid endarterectomy is protective against stroke in patients with asymptomatic severe carotid stenosis. In order to decrease costs and risks, new diagnostic tools have been developed, such as Magnetic Resonance Angiography (MRA), duplex Ultrasound (US) and more recently Spiral Computed Tomography Angiography (CTA). CTA provides excellent 3D angiography images of the extracranial vessels using a volume rendering technique. This study was aimed at prospectively evaluating the accuracy of CTA in the diagnosis of carotid bifurcation. The circle of Willis was also studied during the same bolus injection. DSA was used as the gold standard technique. Surgery was also used for comparison. MATERIAL AND METHODS: Spiral CTA and DSA were performed in 106 carotid bifurcations. DSA was performed in all patients within 48-72 hours of CTA. The degree of internal carotid stenosis was evaluated according to NASCET criteria. Degree of stenosis, presence of calcifications, ulcerations and tandem lesions were reviewed by two different neuroradiologists blinded to each other and to the results of the other technique. In 19 cases the size of residual lumen of the ICA was surgically evaluated and correlated with CTA. RESULTS: There was an overall correlation between CTA and DSA in 94% of cases. Our data are in agreement with the results of the current literature. CT angiograms overrated by one category 6 cases (25%) of mild and one of moderate stenosis (7.14%). Calcifications were seen on spiral CT angiography in 69 (65.09%) carotid bifurcations while DSA detected the presence in 31 (29.24%). Ulcerations were missed by CTA in 3 cases. Five (4.71%) tandem lesions were visualized by DSA distal to bifurcation: 2 (1.88%) were also diagnosed by CTA. The patency of the circle of Willis was assessed in all cases. In 19 cases, the size of ICA stenosis evaluated at surgery was comparable with CTA findings. CONCLUSIONS: In conclusion CTA offers an outstanding alternative to catheter angiography in the evaluation of stenosis-occlusion of the carotid bifurcation. The intracranial circulation can be easily assessed by CTA as well, which allows the study of tandem lesions and of the circle of Willis.

Aged↗
PubMed1997

Early postoperative MRI findings following surgery for herniated lumbar disc. Part II: A gadolinium-enhanced study.

The aim of our study was to evaluate the contrast-enhanced MR imaging (MRI) findings, in the early postoperative period, in unselected patients undergoing lumbar microdiscectomy (15/16 had total resolution of their symptoms). Contrast-enhanced imaging studies were performed, in all 16 patients of our series, before surgery, and at the third postoperative day and, two months after surgery. Postoperative paraspinal muscles enhancement was present in all patients. In the postoperative period, nerve root enhancement was present in 5/16 patients at the early survey and persisted in one after two months. A pseudohernia depicted as epidural intermediate signal intensity tissue, was seen in 13 patients at the third day MRI, and only in eight after two months. This pseudohernia enhanced peripherally in 8/13 patients and enhanced homogeneously in the remaining five at the first postsurgical examination; in the late MRI the peripheral enhancement was appreciable in only two patients while a homogeneous enhancement was observed in six. Clinical symptoms resolved completely in 14/16 patients on clinical evaluation at the third postoperative day, while the remaining two patients showed residual symptoms and signs of radicular compression. At the early MRI these two patients showed intradural nerve root enhancement. Two months later, one patient did not show the previously described nerve root enhancement and improved clinically, while the other had a positive Straight Leg Raising Sign with persistent intradural nerve root enhancement. In conclusion, no correlation between clinical course and contrast-enhancement of pseudohernia and extradural nerve root was appreciable, although intradural nerve root enhancement seems to represent a clinically relevant finding.

Adult↗
PubMed1997

Early postoperative MRI findings following surgery for herniated lumbar disc.

MRI is routinely used in the evaluation and management of patients with failed back surgery syndrome (FBSS). However, its value is unclear in the early detection of signs that can negatively affect that later course of surgical cases. The purpose of the present study is to describe the MR images of early postoperative MRI at 3 days in 30 unselected patients who underwent lumbar microdiscectomy, and to correlate the findings with follow up MRI at 8 weeks and with final outcome. The findings are correlated with literature data. Early postoperative MRI findings were consisting of pseudohernia in 24 patients (80%), annular rent in 23 patients (80%), and other non-specific postoperative findings. On the late MRI the pseudohernia persisted in 12 patients (50%), the annular rent in 4 patients (15%) and asymptomatic pseudo-spondylodiscitis was apparent in 3 patients (10%) as was a case of true spondylodiscitis. Therefore, early postoperative findings have limited value in the management of patients after surgery for lumbar disc herniation, since the images were not correlated with the immediate clinical course after surgery nor with the late radiological and clinical outcome. The evident imaging changes in the early postoperative period after lumbar disc surgery limit the accuracy of the interpretation of MRI examinations.

Discitis↗