MRI experts??
 

I just had an MRI done yesterday nearly two years after my discectomy operation on l5/s1..... Been dealing with off and on pain since then but have muscled through it. No doc visits or narcotics prescribed but I finally had enough and went in. The doc was concerned about some results of the pin prick test so he had an MRI done and I'd like to know what it all means.... Below is the report.... If anyone can translate to normal people speak I'd love you forever. Also, do you think this will mean yet another surgery to fix this mess? TIA.

L3-4: interval development of a broad based disc protrusion producing thecal sac effacement greater to the left of midline.

L4-5: some loss in disc signal intensity. Some generalized bulging of the disc is greater to left producing mild diffuse thecal sac effacement.

L5-s1: some disc signal changes anterolateral to the thecal sac on the left are present and abut the traversing left s1 root and also abut the anterolateral aspect of the thecal sac on the left. Could be fibrosis or some extruded disc material....

Development of a schmorl's node involving the inferior end plate if l5 anteriorly

Thoughts new friends??

No amateur neurologists know what that means?? I'm 30, pretty healthy and I'm worried about having to do surgery again... Apparently my reflex and feeling in the right leg was non-existent or extremely muted at my appt... Considering that with the MRI report am I screwed?

Nothing too serious seen, it depends on how much pain and discomfort you are in. I would try different alternative approaches to surgery. Read up on the condition and educate yourself about it :)

As you are post-surgical, was a contrast study not additionally considered?

Also, history, present complaints and clinical (exam) findings dictate what imaging studies need to be done (and for which findings correlated to said exam findings) so...the thought of diagnosing solely by fractional imaging findings that are retrospective to undetermined history, symptoms and clinical findings is more akin to witchcraft or channeling in it's preminitions and is tantamount to paddeling upstream in flood conditions without oars or floatation device (as a non-swimmer).

I read this and responded late into the night and looking back at it, the area you have trouble with, is the area you had the surgery on.....there should be no disc material there!

Again Dubious is correct that a contrast would have been much more beneficial in this case, and may have helped them to see what the extrusion really is.

Agreed! That's what threw me off. I wasn't expecting to see disc material resting on that nerve root again.... Frustrating!!! I just don't really want to get sliced open again, that was no fun....

I looked it up, apparently it is common to only remove the part of the disc that is causing issue. There fore it is possible to have that issue at that site again.

oh, i know that... it just pains me to see that apparently the surgery was all for naught... having the same exactly problem with bilateral leg pain/numbness when i only had it in one leg two years ago is frustrating! oh well....... :(

They never take ALL the disc material or else you'd have bone on bone. They'd otherwise have to put something in there to replace it.

Correct. I understand that they don't and weren't going to remove the disc but I'm just thrown off by the issue popping back up worse than it was before after 2 years of being EXTREMELY cautious with my back... I'm a young person at 30 and am obvi not ready for non step bed rest or having to act like and 80 year old that can't pick up a grocery bag....

Do you guys think I should try to get this fixed considering the severe nerve pain and numbness/reflex issues in the opposite leg? Need advice bc I don't want to get pushed around by the doctors like last time.

About doctors
 

It is important NOT to feel pushed around by a doctor. It happend to me and I was older. I walked out. Find a doctor you can truely talk to. Any surgery is serious and you want to be absolutly sure it is the right thing to do. I wish you all the best. ginnie:hug:

Thanks! And I agree. I got a call from my neurosurgeons assistant today calling me in for an appointment tomorrow, I guess my neuro called him after reading the MRI report... I'm going to give him a shot as he's widely respected as the best in our area... I'm just nervous that he will recommend fusion since a discectomy was already done at that level.... Fusion has always been a fear of mine... :(

Hi Nacho
 

If you do consider fusion, just know that they too can turn out OK. My first at C6-7 did not. I did the domino thing. Now fused C3-7, and he did a good job. This surgery was successful, so it can turn out OK. Believe me, I was freaked too. I sought multipal opinions before I agreed to it. It was Leesa, who helped me understand my own MRI when I came here. I wish you all the best. ginnie

My surgeon said he does NOT want to operate which was pretty comforting.... Trying some epidurals next week and follow up before Christmas... Hopefully it works and I can put this bs behind me. I'm not trying to go the pain management route either as I know pills aren't the best idea...

I am not a doctor. I am also not an advocate for surgery either. What is kicking my teeth in lately is this bandwagon all of these docs are jumping on with these shots like they are the miracle cure all.

Honestly how is a a nerve root block going to improve that situation? There is a foreign mass touching/rubbing/compressing the nerve root, which is the cause of the pain. Unless the magic formula they have in the shot is a shrinking solution your problem will be there indefinitely. I also don't think medication is always the best answer, but I know of more than a few people who have received the epidurals and after they essential overdosed the body over a series of injections they are worse off than they were before. The steroids are TERRIBLE to the rest of the body!

I could be wrong. It is open for discussion as this is a discussion board, but that is the way I see it. Dubious may chime in and have a better perspective but so far as I know there isn't a therapy that will retract that extrusion, nor a shot that will either. The body will not absorb it either. From what I read it seems that it would be a simple procedure to remove that piece with no other ortho work needed just a snip and cauterize, if that is even needed. It could probably even be done arthroscopically. Just my himble .02 and whatever way you go you have my thoughts and prayer's!