To assess the impact that routine postoperative radiographs have in clinical outcome and clinical decision-making.
Summary of Background Data. No standard exists that outlines how often and when radiographs should be taken after lumbar fusion. Routine postoperative radiographs can Nutlin-3 concentration be a source of inconvenience and cost to patients, radiation exposure, and possibly, confounding information.
Methods. The patients who underwent a single or multilevel lumbar instrumented fusion were investigated. At each time-point after surgery, it was noted if they demonstrated new symptoms or clinical deterioration. The Fisher exact
test was used to analyze the categorical data.
Results. Sixty-three patients (25 males and 38 females) were identified with a mean age of 52 years (range, 20-87). Plain radiographs were taken at 269 visits including all time-points. In 17 (6.3%) visits, abnormal findings were found in 13 patients, including suspected pseudoarthrosis on radiographs (n = 10) and adjacent segment disease on radiographs
(n = 3). They were found during 11 of 50 visits (22%) in the patients with new symptoms or clinical deterioration and during 6 of 219 visits (2.7%) in the asymptomatic patients. The probability of an abnormal finding was significantly lower in the asymptomatic patients (P < 0.001). Before the 6-month follow-up, abnormal findings were found in 1 of 111 visits (0.9%) and in 16 of 158 visits (10%) at the 6-month follow-up or later. The probability of an abnormal finding Milciclib order was significantly KU-55933 research buy lower before the 6-month follow-up (P < 0.001). In six of the seven symptomatic patients (86%) with suspected pseudoarthrosis on radiographs, pseudoarthrosis was initially suspected between 6 and 12 months after surgery.
Conclusion. This study suggests that plain radiographs should be performed as indicated clinically
rather than routinely after instrumented lumbar fusion. The vast majority of asymptomatic patients do not require routine postoperative radiographs.”
“Purpose: To compare the diagnostic accuracy of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in the detection of colon lesions with that of delayed PET/computed tomography (CT) performed after the administration of a laxative-augmented contrast medium.
Materials and Methods: All patients gave written informed consent according to the guidelines issued by the institutional review board. In a prospective study performed from November 2005 to December 2006, images obtained in 847 patients were reviewed by two physicians in consensus. Colorectal FDG uptake on initial PET images that exceeded background FDG accumulation was graded as minimal, equivocal, or positive. When the initial PET scan revealed a colorectal region of increased uptake, either oral or anal laxative-augmented contrast medium was administered on the basis of the site of colorectal FDG focus and delayed PET/CT was performed.