E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Early Postoperative MRI After Endoscopic Lumbar Discectomy: Is There a Clinical Correlation?
tolga türkmen✉ ,
hande kavaklı ,
mehmet karaaslan ,
AYDEMİR KALE
mehmet karaaslan ,
AYDEMİR KALE
Department of Neurosurgery, Gazi University; Department of Neurosurgery, Gazi University Faculty of Medicine
Accepted: 15/08/2026
Article in Press
Corresponding Author:
tolga türkmen (tolgaturkmen@yahoo.com.tr)
Abstract
Aim
Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive alternative to conventional discectomy. However, whether routine early postoperative magnetic resonance imaging (MRI) is necessary to evaluate residual disc material and predict clinical outcomes remains unclear. This study aims to investigate the association between early postoperative MRI findings and clinical outcomes following PELD.
Material and Methods
This retrospective analysis included 30 patients who underwent PELD for lumbar disc herniation. Patient demographics, surgical characteristics, and preoperative and postoperative clinical scores (Visual Analog Scale [VAS] and Oswestry Disability Index [ODI]) were analyzed. Residual disc material on early postoperative MRI was classified into four grades: total excision (Grade A), <25% residual (Grade B), 25%–75% residual (Grade C), and >75% residual (Grade D). VAS scores were assessed preoperatively, on the first postoperative day, and at 1 month postoperatively, while ODI scores were obtained preoperatively and at 1 month after surgery.
Results
Although residual disc material was identified in 22 patients on early postoperative MRI (Grade A: 8, Grade B: 11, Grade C: 8, Grade D: 3), all patients demonstrated significant clinical improvement. Preoperative VAS scores averaged 8.0 [IQR: 7.0–8.0], decreasing to 1.0 [IQR: 1.0–2.0] on postoperative day 1 and remained at 1.0 [IQR: 0.0–1.0] at postoperative month 1. The mean ODI scores improved from 74.6 preoperatively to 7.8 at postoperative month 1. These findings suggest that residual bulging on early postoperative MRI does not necessarily correlate with clinical outcomes.
Conclusion
Early postoperative MRI frequently demonstrates residual bulging after PELD; however, in this limited cohort, the extent of residual bulging was not significantly associated with early clinical improvement. These findings should be interpreted in conjunction with clinical status, and early MRI may provide useful feedback for technical refinement, particularly during the learning curve.
Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive alternative to conventional discectomy. However, whether routine early postoperative magnetic resonance imaging (MRI) is necessary to evaluate residual disc material and predict clinical outcomes remains unclear. This study aims to investigate the association between early postoperative MRI findings and clinical outcomes following PELD.
Material and Methods
This retrospective analysis included 30 patients who underwent PELD for lumbar disc herniation. Patient demographics, surgical characteristics, and preoperative and postoperative clinical scores (Visual Analog Scale [VAS] and Oswestry Disability Index [ODI]) were analyzed. Residual disc material on early postoperative MRI was classified into four grades: total excision (Grade A), <25% residual (Grade B), 25%–75% residual (Grade C), and >75% residual (Grade D). VAS scores were assessed preoperatively, on the first postoperative day, and at 1 month postoperatively, while ODI scores were obtained preoperatively and at 1 month after surgery.
Results
Although residual disc material was identified in 22 patients on early postoperative MRI (Grade A: 8, Grade B: 11, Grade C: 8, Grade D: 3), all patients demonstrated significant clinical improvement. Preoperative VAS scores averaged 8.0 [IQR: 7.0–8.0], decreasing to 1.0 [IQR: 1.0–2.0] on postoperative day 1 and remained at 1.0 [IQR: 0.0–1.0] at postoperative month 1. The mean ODI scores improved from 74.6 preoperatively to 7.8 at postoperative month 1. These findings suggest that residual bulging on early postoperative MRI does not necessarily correlate with clinical outcomes.
Conclusion
Early postoperative MRI frequently demonstrates residual bulging after PELD; however, in this limited cohort, the extent of residual bulging was not significantly associated with early clinical improvement. These findings should be interpreted in conjunction with clinical status, and early MRI may provide useful feedback for technical refinement, particularly during the learning curve.
Keywords
Early Magnetic Resonance Image
Endoscopic Discectomy
Lumbar Disc Herniation
Pain Relief
Early Clinical Outcomes