One Year After Surgery, MRI Does Not Identify Recurrent Sciatica
(HealthDay News) – For patients treated for sciatica and lumbar-disc herniation, magnetic resonance imaging (MRI) performed at one year does not distinguish between those with and without favorable outcome, according to a study published in the March 14 issue of the New England Journal of Medicine.
Abdelilah el Barzouhi, MD, from the Medical Center Haaglanden in The Hague, Netherlands, and colleagues examined the correlation between findings on MRI and clinical outcome in 283 patients enrolled in a randomized trial comparing surgery with prolonged conservative care for sciatica and lumbar-disc herniation. At baseline and after one year, patients underwent MRI.
The researchers found that 84% of the patients reported having a favorable outcome (complete or nearly complete disappearance of symptoms) at one year, including 85% of those with disc herniation and 83% of those without disc herniation (P=0.70). Disc herniation was seen in 35% of those with and 33% without a favorable outcome (P=0.7). MRI assessment of disc herniation did not differentiate between patients with favorable and unfavorable outcome (area under the receiver operating characteristic curve, 0.48).
"In summary, in patients who had undergone repeated MRI one year after treatment for symptomatic lumbar-disc herniation, anatomical abnormalities that were visible on MRI did not distinguish patients with persistent or recurrent symptoms of sciatica from asymptomatic patients," the authors write.
Several authors disclosed financial ties to commercial entities, including medical device and insurance companies. One author provides legal expert testimony for medicolegal cases.