MRI examination was performed in 9 postlaminectomy patients because of clinical symptoms of lumbar disc disease (FBSS - failed back surgery syndrome). The efficacy of the common protocol of T1W spin echo (SE) images before and after i.v. Gd-TPA contrast was compared with the protocol enriched with fat suppresed (SPIR) T1W SE images before and after i.v. contrast matter. Moreover, in 4 patients the MRI examination after a regular dose of Gd-DTPA (0.1 mmol/kg) continued with application of 0.2 mmol/kg Gd-DTPA and a new MRI exam. The application of a triple dose of Gd-DTPA improved neither the sensitivity nor the specificity of the examination. Higher sensitivity was achieved using SPIR technique, but specificity did not change. Improved sensitivity could be beneficial for differentiation between recurrent herniation and epidural fibrosis and may thus help to decide the etiology of clinical symptoms more precisely. The scar post Gd-DTPA enhancement diminishes with the time interval after the operation. Therefore patients who are long after operation may profit most from fat suppressed T1W SE (SPIR) images.

        Key words: magnetic resonance imaging - epidural fibrosis - recurrent herniation - SPIR technique