MRI Results following fusion
 

I had a TLIF spinal fusion in Feb of L4-s1 and have continued to have pain. Just recently I have started to have sciatic pain again as well as just general pain in my lower back. I received my CT scan result back that show a bulging disc at L4 plus foraminal narrowing at L5-S1. My MRI results came back as follows:

Right larger than left extra axial multioculated cystic lesions within the spinal canal. There is minimal posterior mass effect on the thecal sac. There is left greater than right stenosis secondary to persitent low grade anterolisthesis of L5 on S1.

Persistent neruoformainal stonosis at L5-S1.
Extra axial cystic lesions anteriorly within the spinal canal most like seroma.

Anyone have an ideas if this could be causing my pain? Is unusual that L5 is slipping again after having a fusion only months ago? Is it unusual to have foraminal narrowing again after such a short time after surgery?

It IS unusual for it to be slipping after such a short time after surgery. If I were you I'd get another opinion, although another doctor might be reluctant to give you advice since someone else did the surgery. This could be a sticky situation, but you REALLY need someone else to look at you.

See if you can get a referral to someone else. Seems to me that your surgeon didn't do a "real good job" when he operated on you. But that's just my opinion, and I'm no doctor.

Please keep us posted, ok? I wish you the very best. Hugs, Lee :)

So I found out today that I am having issues with my SI joints and that is causing my pain. I saw the pics of the MRI and there is definitely space for the nerves so where it says there was an issue with that, there really isn't. Not sure why the radiologist said that when I clearly could see on the MRI they weren't. There is a cyst for sure that has formed and we are gonna keep an eye on it.

Have you had any Epidural steroid injections? Were they painful? Did they help?

Weren't your S1 joint issues picked up in the pre-op testing or when the surgeon was in there? Curious. I agree with Lee and would want a second opinion. Best wishes.

I didn't have pain like this pre surgery so there wasn't any issues with my SI joints before. It has occured since my fusion. I think the stress from having the fusion has caused issues with my SI joints.

It appears that even though I had a fusion that he couldn't pull the vertebrea back all the way into a normal position. I had a grade 3 slip before and it is now a grade 1. Is that normal? Should it have been put completely back so there isn't type of slip?

I am a bit confused. I didn't think MRI's could be done when there is fusion because of the rods and screws. I had fusion of L4-5 about 5 1/2 years ago.

Also, the surgeon advised me before doing the surgery that I had been in a tipped position and would remain so because the hardware would follow the position of my vertebrae.

I agree with the others though; another opinion would be a good idea. It does not mean you are having someone else do any work additional work. I had gone to another orthopaedic surgeon regarding cysts that had been present during the original surgery and was concerned they might have come back. He had a myelogram done which showed the cysts had not come back. He did also let me know he felt any additional surgery was not going to be helpful even tho I stil had other problems going on. Recommended a good Pain Specialist for me. Going to someone else did not mean I was leaving my original surgeon; just getting more info.

I have had epidural injections done with mild sedation. They were not too uncomfotably.

Hope all turns out well.


(Gerry)

The rods are titanium and you can have an MRI with them. .The pictures are just not as clear as it would be without rods.

I am wondering if I was just so far slipped that I might not ever be back to a "normal"spine.

Do they know what the cysts come from?

Dear Candle girl
 

I am sorry to hear your report. I am not an expert, just know a little. I would be worried a bit too and seek another doctor. This kind of thing where you have problems so quick after the first fusions does seem unusual. You need to get better answers from your neruosurgeon, about this test, and then maybe seek another opinion with your latest test. Stay strong. Sometimes people do have second fusions, and turn out just fine. I am one. ginnie:hug:

I know this sounds like a super dumb question but after a fusion I should be in perfect alignment? I should not still have a grade 1 slip. Correct?

I do wonder how I am having issues with my SI joints this early on too. Add to that the fact that I have a small amount of bone growth but not what it normally should be, I am beginning to wonder what is going on.

Hi candlegirl
 

Alignment is not great with my spinal fusions. But he did the best he could do since I reversed the curve of my spine. I was told this normal and that everybody has different outcomes regarding this. When the surgeon does the surgery, it is dependant on each persons problem how well they line up. This is not a reason in itself not to have a good outcome. I sure hope that your continued problem can be addressed. ginnie:hug:

Okay, so it isn't abnormal to still be slipped a little:) That relieves my mind a bit. So thanks! I had a large slip and it was almost bone on bone with those vertabrae. The height between the discs is now normal just still slipped but nowhere near what it was. My NS showed me before and after pics and I am still amazed at how bad my back was to start with and how long I lived with it. I am praying hard for a good result and that it is a matter of time that it heals and the pain stops. THe pain now is worse than the pain before and I would love some relief from that.

Thanks Ginnie:D

Hi, about questions
 

No questions are dumb. We are all learning together here, and welcome all questions, comments, and give some support at the same time. Yes your conditions is a bit unusual with the report, but I would just get that second opinion or third, more information about what is going on the better. Leesa, is the best on research. I am here anytime you need to talk or have a question. I had plenty of my own questions when I faced my fusions. In fact I was a basket case. All turned out OK, and I really hope it can for you too. ginnie:hug:

Hi once again
 

I was bone on bone as well. I have the concern that your pain however should have gone down a bit, not get worse. How far into recovery are you time wise? will reply later, have an appt. Take a deep breath, this can and does have resolution alot. My rod is C3-7 and crooked. first at C6-7 didn't resolve, had another C3-7. I am OK for the most part. I will get back to you. You can PM anytime too. ginnie:hug:

I am six months out from surgery. My symptoms match the SI joint issues perfectly. Rolling over in bed, sitting and walking are awful. I stopped pain meds three months ago but am now back on Tramadol. I am going to restart PT and hoping the ESI injections in my SI joint help. Have to call tomorrow to schedule. My CT scan shows mild SI joint changes bilaterally. It is frustrating how the fusoin has already caused issues elsewhere and I am only six months out. It scares me so bad to think of the future and what else is going to wear out and how fast.

Hi Candlegirl
 

Six months was still a bit testy for me. I hope the injection works. I did as much PT as my insurance would let me. If you can do it again that may help. How long did you do the PT for? How far into recovery did you start? I was at 4 weeks, and scared. I sure hope you don't have to do anymore surgery. Do all the other protocals first and try everything that your neurosurgeon gives in tips. Seeking another opinion never hurts. Just keep that journal to bring with you, that really helps them to understand when and where your pain is. Have you tried to sleep on a wedge? ginnie:hug: (gel wedge, gel pillow are what I used and still do)

I hope the injections work too. The pain clinic I go to usually takes quite awhile to get into and I was lucky enough that someone cancelled their appointment right before I called and I can get in next week. I am hoping to get the injections very soon after the intial appt with the pain doc. I start back working full time at school in two weeks. I am a bit worried how I will cope and my back will do working again. I haven't worked since two days before my surgery in February. EEK!!!

Have you had the ESI's? I am scared to death to have them done but they aer a much better alternative than having to have surgery again.

I sleep with a pillow under my legs at night. Where did you find a gel wedge? I am what my hubby calls a rotisserrie at night so I need a smaller wedge since I roll around so much:)

Hi Candle Girl
 

The wedge was through a medical supply magazine. Called "Easy Comforts"
1-800-308-1384, or 250 City Center, Oshkosh, Wi. 54906. All shapes and sizes, it is worth a try. I had infusions before my last surgery. They did help, and lasted a few months. However the problem was there and didn't go away. Fused C3-7 now, and doing OK after that second one. Hope you do not need to have more. School will be kind of tough, wear good orthodics, gel inserts, and maybe even in class a gel seat, to take the stress points off your back. I did not get the kind of injection you are getting. From what I understand, they can help. The two infusions I got didn't hurt at all, and I sure hope that happens that way for you. Numbed me first and used a floroscope for imaging. Doc. was good. Glad you are getting into the doctor next week. I know it can't come soon enough for you. Maybe you could go even earlier, by putting your name down in case they have another cancelation. I hope your doctor is gentle and that you get the relief you need. All my best. ginnie

I will definitely look that up and order one. Laying in bed and sitting is just plain awful right now. I am so tired of not being able to sleep.

I did buy Skechers dress/work shoes. They are pretty darn comfortable and much better than the other shoes I have. I have not been out of sneakers since my surgery so I have been wearing the dress shoes around the house alot to make sure they will work for a full day of work. I am excited and yet VERY nervous to go back to work because of my back.

Hi Candle Girl
 

I hope you can work candle girl, and that the pain is tolerable when you do. It is awful to loose your job or business. I am working on a bucket list right now, and doing those things that I can do, while I am able in limited ways. I miss working more than I ever thought possible. Take care and let me know how your injection goes. I hope it brings relief. Ginnie:hug:

candlegirl i wanted to let you know that doctors do not always put your lumbar spine back to original allighnment,your spine adjust to having anteriorlisthesis and if you put it back in correct allighnment it could cause problems and vertebras could touch one another. i was spondylolisthesis 3 and now a 1.

I did ask and was told that it is much better and cannot always be perfect.

Had my si joint injections and the one side of my back is soooo much better while the other side feels like someone is punching me in the back. Argh.

I'm a little late, but I had these injections and they NEVER worked. And I had ALOT of them too, and not once did they work, darn it. :mad:

Every single kind of injection you can have, I've had them and none of them worked. I don't know what there is about me, but I guess i'm strange. LOL
I'm really hard to medicate too -- I wake up on operating room tables during surgery too. I've done that 3 times now -- I hope that's the end of it. :eek:

Let us know how long the relief lasts, ok? God bless & take care. Hugs, Lee

Hi Leesa
 

Did you try Katemine infusions? This did help me where other kinds of injections did not. I hate all needles anyway. ginnie