CONTRAST-ENHANCED MR-IMAGING IN ACUTE LUMBAR RADICULOPATHY - A PILOT-STUDY OF THE NATURAL-HISTORY

PURPOSE: To prospectively study clinical findings and contrast materia l-enhanced magnetic resonance (MR) images over time in patients with a cute lumbar radiculopathy. MATERIALS AND METHODS: Twenty-five patients underwent physical examination and MR imaging at presentation, 6 week s, and 6 months. Initial symptoms and clinical course were correlated with type, size, location, and enhancement of disk herniations. RESULT S: Eighteen patients had a herniated nucleus pulposus (HNP) at one or more levels, two had synovial cysts and stenosis, and five had normal findings. Patients with an HNP had marginally more severe neurologic s ymptoms than did patients without an HNP (P = .07) at presentation. Tw enty-two patients completed the 6-week examinations and 14 patients th e 6-month examinations; three patients were eliminated from the study after surgical treatment. Among HNPs larger than 6 mm, substantial red uction in size was noted in 36% at 6 weeks and in more than 60% at 6 m onths after presentation. CONCLUSION: Agreement between clinical and M R findings for level and side of HNP and radicular symptoms was excell ent. There was no correlation of pain and disability with disk size, b ehavior, or type.