Accuracy of Marker Placement by Magnetic Resonance Imaging in the Determination of the Incision Site in Lumbar Disk Surgeries

Abstract

Background: Lumbar disk surgery requires precise determination of the desired vertebral space to allow the neurosurgeon to incise and dissect the correct space. The aim of this study was to assess the accuracy of marker placement by magnetic resonance imaging (MRI) in determining the incision site in lumbar disk surgeries. Materials and Methods: A total of 26 patients who were candidates for lumbar disk surgeries were studied. An oil nifedipine capsule was placed on the skin of the patient on any place on the vertebral line. Then, a T2-weighted sagittal MRI was performed in the prone position. The distance between the herniation site and the oil capsule density was calculated by an MRI software, and then it was measured on the vertebral line to place the marker. Thereafter, a transient tattoo pen was used to place the marker to guide the neurosurgeon to the herniation site. The neurosurgeon reported the correctness of the placed marker after observing the pathologic site during the operation. Results: The mean age of the 26 patients was 50.4 +/- 14.2 years. Of the study patients, 12 (46.2%) were male and 14 (53.8%) were female. Postoperative follow-up of the patients revealed that in 25 patients (96.2%), the placed marker was correct. Conclusions: This study revealed that marker placement by MRI is a precise technique for the determination of the incision site in lumbar disk surgeries. This method may replace the conventional methods for surgical site determination in lumbar disk surgeries because it provides a safe and exact technique.