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?

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

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.

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