Please help post laminectomy L4/L5 Jun 2011 now more issues.
 

Hi I had an emergency laminectomy June 2011 and now I am having more issues. I believe my Dr forgets who I am in between visits and tells me something different every time. This time he said he could not figure out why I am having so much pain over a small bulge. Can you please help me interpret my last MRI (after my laminectomy) that was done in Aug 2012. I believe this is more than a small bulge and he has maybe mixed me up with another patient? Am I being a wimp or could these thing be causing my back pain? He has scheduled me a nerve test for feb 1. Also do you know what high intensity zone means? Thank you so much in advance for any insight.


Tll-Tl2,T12-LI andLl-L2 Level: No signihcant disc bulge is seen. The spinal canal and nerve root
foramen appear widely patent.
L2-L3 Level:5 mm posterior disc protrusion with a high-intensity zone. This does not narrow the spinal
canal or nerve root foramen.
L3-L4 Level: 3 mm posterior disc protrusion with a high-intensity zone. This does not narrow the spinal
canal or nerye root foramen.
L4-L5 Level: Postsurgical changes consisting of a right L4 laminectomy. There is enhancing scar tissue at
the laminectomy site and around the right L5 nerve root in the right lateral recess. There is a 4 mm right
paracentral enhancing disc extrusion which contacts the right L5 nerve root in the right lateral and displaces
it towards the facet joint. There is no signihcant stenosis of the spinal canal. There is mild narrowing of the
nerve root foramen.
L5-Sl Level: No significant disc bulge is seen. The spinal canal and nerve root foramen appear widely
patent.
There is no paraspinous mass or intradural mass. The conus medullaris ends at the level of T12-L1 and appears unremarkable.

Impression:
I . Postsurgical changes at the L4-L5 level consisting of a right L4 laminectomy. There appears to be a
residual recurrent right paracentral disc extrusion which results in mild to moderate stenosis of the right
lateral recess, displaiing the right L5 nerve root against the facet joint. The right L5 nerve root may be
compromised to some degree and clinical correlation regarding right L5 radiculopathy is recommended.
2. Posterior disc protrusions at the L2-L3 andl3-L4 levels without significant spinal stenosis.

Sorry for any mispelling/typos adobe reader did not pull all of the information over correctly for some reason!

I had a laminectomy operation (and other decompression measures) in 2006. I was left with poor mobility and ever present neuropathic pain, which is pretty well what I had before the operation. I can't comment on the detail of your MRI report, needs someone with real professional/technical knowledge IMO. But I did share in some measure the confusing, and sometimes sketchy, reports I was given after the operation.

At the time the partial and inconsistent information was confusing and somewhat scary, leading to a degree of paranoia for me. After 18 months seeing various specialists I did manage to extract a sort of diagnosis (myelomalacia = softening of the spinal cord). Reflecting on it afterwards (I've had plenty of time!) my best guestimate is that the root problem for doctors may be that conditions of this sort are really difficult to identify precisely, leading to different responses at different times.

Sorry if this isn't very helpful or optimistic, but it is my experience as best I can interpret it.

Thank you at least it makes me feel better that Im not the only one hurting and its not just in my head :)

Hmmm. At L2-3 You have a good size herniated disc (with a high intensity zone?) Not sure what that means.

You have another at L3-4 with a high intensity zone.

At L4-5 you have scar tissue around the nerve root (ouch!) and it displaces it towards the facet joint which also results in mild to moderate stenosis

Just the scar tissue alone around the nerve root is enough to cause pain, let alone the other 2 herniations you have. It's no wonder you have pain.

I'm going to have to do some research on what "high intensity zones" mean. I don't know that either.

The "nerve tests" are NOT 100% accurate so unfortunately we can't rely on them completely but they might give some idea of where the problem lies or IF there is a problem. Let us know what you find out. Hugs, Lee ;)

sdchic1
 

I also had surgery in 2006. L4-5 fusion and laminectomy with nerve damage. Still hurting and on narcotics to help make pain tolerable.

Unfortunately, Pain is what we all have in common.

Gerry

Laminectomy
 

Lamectomy in August, 2010
 

I had a nerve wrapped around my lumbar spinal column removed 2 1/2 years ago and have had ever increasing pain from L2-S1 as well as from my back down through my right leg. I have been deteriorating in mobility and pain ever since. Has anyone found relief from it? All I have is heat for my back and ice for my knee. I have been told it is Osteoarthritis. :mf_swordfight::mf_swordfight:

Hi Becky ~ I had a Rhizotomy, and it didn't help at ALL. :( It was a total waste of time. I was SO disappointed cause I'd had the pain for years & years, and I STILL have it. It's been 27 years now. :( No one can figure it out, or get rid of it. So we just medicate it. Whoopie. :rolleyes:

I hope the Rhizotomy works for you! Many people get relief from it. I'm sure you'll be one of them. God bless and keep us posted. Hugs, Lee :D

Becky, I have had severe spinal issues since I was 12, I am now 49. After many surgeries, procedures, TENS, pain pumps, stimulators, ongoing PT, alternative medicine etc I finally tried the rhizotomies.

Since I have issues with severe canal stenosis at L5-S1 and prior fusions at L4-5 the rhizotomies were done at those levels on both sides.....I had some relief from the diagnostic nerve blocks that I had to have prior to the rhiz.
I got no relief from the rhiz.

However, that does not mean that you won't get relief. Many people get relief and can get back to an active lifestyle - others don't.

The best part of my story is that three weeks ago I had my first caudal ESI - I have had lumbar ESI's every other year for about 20 years or so - with no effect and I was not hopeful about the caudal ESI. About 6 days after the injection I woke up and was blown away - after so many years of horrific leg pain and butt pain and back pain etc - I have some relief....crazy.

I am new to pain relief - I still have trouble with my legs but the pain is soo-oo much better that now I am starting to reduce my pain meds....wow.

You may want to consider a caudal ESI - it changed my life.

Caudal ESI
 

:eek::eek:What exactly is this procedure? I have had 3 series of guided facet steroid injections, the results to the pain were very short lived. However, it was good enough to get me into a large Toronto Hospital, where I am scheduled for a lumbar Rhizotomy in April.

I have taken every category of pain meds for 30 years with absolutely no pain relief and unbearable side effects. Some actually increased the pain in my body. Right now there is no other option because of the overwhelming presence of osteoarthritis spreading rapidly.:confused::confused:

Caudal ESI
 

The caudal ESI is an epidural steroid injection done into the caudal area of the spine - right at the butt crack if you want to get technical LOL.

I am like you in terms of pain meds and 30 years of everything tried....and I am still amazed at the relief I have gotten and still have from the caudal ESI.

I have had many ESIs, I may infact hold the world's record on lumbar and cervical and shoulder ESIs received in a lifetime. However, I never even knew about caudal ESIs....not sure why my doctor would not have tried it since my L5-S1 is severely munched. (The caudal area I believe starts in the Sacrum and looks like a tail)

I even did the rhizotomies - with no relief - but do not despair - many people have gotten incredible relief from them.....and you should count yourself blessed that you still have stuff to try.

You may want to hold the caudal ESI treatment as something you try after the rhizotomies - although I strongly believe you will get pain relief from the rhizos (think it will work - put it out there and many times your positive thoughts produce good fruit!)

Prayers go with you.

Kelli

Dear sdchic, I think we meet again, hi im sorry this is happening to you. To be short ive had 4 lum lams & pain for 30 years, severe, chronic on fentanyl patch pain. Ok, the EMG will most likely show L5 nerve root irritation because my leg wouldnt work & hurt so much i had to go to my parents! Married with little kids! Either the worst pain in leg to date or on a normal EMG check the result was nerve root irritation. The main reason to do surgery is when there is compression on the thecal sac or spinal canal same thing or there is nerve compression as the nerve exits to go out of the spinal column or the neural foramen.
Your radiologist says that these are not a problem on every level but he specifically adds that the L5 nerve root is being held against the facet joint or bone by scar tissue. So, you had part of this disc removed but the nerve now has a blob of disc material on it & its trapped by scar tissue against bone. This needs to be resolved by surgery where your neurosurgeon takes the disc material out, lasers the scar tissue & untraps the nerve root by shaving down the facet joint or hopefully b/c of possible future stability issues can just move the nerve away from the bony facet joint.
However, no surgeon will want to go back in for one year & may try epidural steroid injections, PT & anything else to get the bulging, really extruded disc
to go back off the nerve. My son had a herniated disc & 1 ESI made it completely resolve. So, we pray & hope that this happens! Oh my sympathies & empathies to you sweetheart, just recovering & this pain! After spine surgery all has to settle, nerves, ligaments, tendons, muscles even discs have to redistribute the weight & carry the load that that level omce did. A disc is like a tough sac containing semisolid gel center & if the surgeon cuts the herniated part off it makes sense to me that some of that "center" could leak out very easily. God bless you!

Dear becky, Just because this condition is so elusive, i had it on my MRI from 1988 but no dr told me until 2012, its called arachnoiditis. Diagnosis is made by MRI with the following words clumping of nerve roots or peripheral clumping of nerve roots. Sometimes will say possible tethered cord or possible arachnoiditis. Im not suggesting that you have it of course! But, look at your MRI reports or maybe ask your dr if he has seen anything like that, i hope that you have low pain days! Gentle hugs!