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Hi Everyone. My name is Angela. I had a PILF Feb.5, 2015, before that epidural steroid injections and and epidural when I gave birth 21 years ago. I recently had Xrays and a MRI done to follow up and see why I am in so much pain and as a follow up after surgery. When I Google the results of my MRI Arachnoditis keeps coming up. I am due for a follow up on the 25th of this month. Any help would be greatly appreciated. I am only on Flexeril for spasms to help me sleep. No-one offers pain pills or nerve pills and I'm afraid to ask because I don't want them to think that I'm pill seeking. I will post both results. I'm really depressed because I really just want to be normal. I'm a plumber and it takes all I have to make it through the day.

IMPRESSION:
Posterior instrumentation L5-S1 with interbody implant. Grade two 1.5 cm
L5-S1 anterolisthesis, unchanged between flexion and extension views.
Minimal 2 mm grade 1 retrolisthesis L1-L2, unchanged between flexion and
extension views.Possible pseudarthrosis right L5-S1.Right upper quadrant surgical clips.
Lower lumbar spine facet arthrosis.Mild bilateral sacroiliac joint osteoporosis.

RESULT: Examination:
MRI of the lumbar spine without contrast

Clinical Information:
Low back pain. Status post prior surgery.

Technique:
Standard multiplanar, multisequence MRI of the lumbar spine without
contrast

Comparison:
Plain radiograph of the lumbar spine dated 3/28/2016

Findings:
Postsurgical changes status post posterior segmental instrumentation and
L5-S1 with bilateral pedicle screws and connecting rods. Status post
laminectomies at L5 and S1. Postsurgical changes in the posterior soft
tissues.

There is a grade 2 anterolisthesis of L5 with respect to S1 measuring 8
mm. Vertebral body heights are normal. Marrow signal is normal. The conus
terminates at the T12-L1 level.

There is linear scarring within the L5-S1 thecal sac, with peripheral
displacement of the nerve roots at this level. Loculated adhesions are
also present at the S1 level , possibly associated with an intrathecal
CSF loculation, versus perineural cysts at the right S1 level. This
results in mild mass effect of the traversing lower right-sided sacral
nerve roots.

There are 5 nonrib bearing lumbar type vertebral bodies with the L5
vertebral body identified by the iliolumbar ligament lumbosacral angle.

Vertebral body heights are normal. Marrow signal is normal.

L1-L2: Spinal canal and neural foramina are patent.
L2-L3: Spinal canal and neural foramina are patent.
L3-L4: Spinal canal and neural foramina are patent. Mild bilateral facet
arthropathy with small facet joint effusions.
L4-L5: Small central disc protrusion. No significant associated spinal
canal narrowing. Mild bilateral facet arthropathy without significant
neural foraminal narrowing.
L5-S1: Status post posterior decompression with dorsal displacement of
the thecal sac. The dorsal margin of the thecal sac has a slightly
tethered appearance and there is abrupt narrowing of the thecal sac at
the L5-S1 level. Anterolisthesis results in mild bilateral neural
foraminal narrowing, the evaluation of which is limited due to
susceptibility artifact from hardware.

IMPRESSION:
1. Postsurgical changes status post laminectomy at L5 and S1 and
posterior segmental fusion L5-S1. Grade 2 anterolisthesis L5 with respect
to S1 measuring 8 mm.
2. Postsurgical change in the thecal sac L5-S1 levels, with peripheral
displacement of the nerve roots which may reflect scarring and sequela of
arachnoiditis. CSF loculation due to scarring, versus perineural cyst,
right S2 level, with resultant mild mass effect and displacement of the
surrounding lower right-sided sacral nerve roots.

So what do y'all think? I seriously DO NOT want any more surgeries.
I'm so nervous about what the surgeon is going to say. He wasn't very friendly with me and made me agree to certain terms if he was going to help me. Stop smoking, see a PT at least once and get the MRI before I saw him again on the 25th.


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[QUOTE=Anj75;5413705]Hi Everyone. My name is Angela. I had a PILF and laminectomy Feb.5, 2015, before that epidural steroid injections and and epidural when I gave birth 21 years ago. I recently had Xrays and a MRI done to follow up and see why I am in so much pain and as a follow up after surgery. When I Google the results of my MRI Arachnoditis keeps coming up. I am due for a follow up on the 25th of this month. Any help would be greatly appreciated. I am only on Flexeril for spasms to help me sleep. No-one offers pain pills or nerve pills and I'm afraid to ask because I don't want them to think that I'm pill seeking. I will post both results. I'm really depressed because I really just want to be normal. I'm a plumber and it takes all I have to make it through the day.

IMPRESSION:
Posterior instrumentation L5-S1 with interbody implant. Grade two 1.5 cm
L5-S1 anterolisthesis, unchanged between flexion and extension views.
Minimal 2 mm grade 1 retrolisthesis L1-L2, unchanged between flexion and
extension views.Possible pseudarthrosis right L5-S1.Right upper quadrant surgical clips.
Lower lumbar spine facet arthrosis.Mild bilateral sacroiliac joint osteoporosis.

RESULT: Examination:
MRI of the lumbar spine without contrast

Clinical Information:
Low back pain. Status post prior surgery.

Technique:
Standard multiplanar, multisequence MRI of the lumbar spine without
contrast

Comparison:
Plain radiograph of the lumbar spine dated 3/28/2016

Findings:
Postsurgical changes status post posterior segmental instrumentation and
L5-S1 with bilateral pedicle screws and connecting rods. Status post
laminectomies at L5 and S1. Postsurgical changes in the posterior soft
tissues.

There is a grade 2 anterolisthesis of L5 with respect to S1 measuring 8
mm. Vertebral body heights are normal. Marrow signal is normal. The conus
terminates at the T12-L1 level.

There is linear scarring within the L5-S1 thecal sac, with peripheral
displacement of the nerve roots at this level. Loculated adhesions are
also present at the S1 level , possibly associated with an intrathecal
CSF loculation, versus perineural cysts at the right S1 level. This
results in mild mass effect of the traversing lower right-sided sacral
nerve roots.

There are 5 nonrib bearing lumbar type vertebral bodies with the L5
vertebral body identified by the iliolumbar ligament lumbosacral angle.

Vertebral body heights are normal. Marrow signal is normal.

L1-L2: Spinal canal and neural foramina are patent.
L2-L3: Spinal canal and neural foramina are patent.
L3-L4: Spinal canal and neural foramina are patent. Mild bilateral facet
arthropathy with small facet joint effusions.
L4-L5: Small central disc protrusion. No significant associated spinal
canal narrowing. Mild bilateral facet arthropathy without significant
neural foraminal narrowing.
L5-S1: Status post posterior decompression with dorsal displacement of
the thecal sac. The dorsal margin of the thecal sac has a slightly
tethered appearance and there is abrupt narrowing of the thecal sac at
the L5-S1 level. Anterolisthesis results in mild bilateral neural
foraminal narrowing, the evaluation of which is limited due to
susceptibility artifact from hardware.

IMPRESSION:
1. Postsurgical changes status post laminectomy at L5 and S1 and
posterior segmental fusion L5-S1. Grade 2 anterolisthesis L5 with respect
to S1 measuring 8 mm.
2. Postsurgical change in the thecal sac L5-S1 levels, with peripheral
displacement of the nerve roots which may reflect scarring and sequela of
arachnoiditis. CSF loculation due to scarring, versus perineural cyst,
right S2 level, with resultant mild mass effect and displacement of the
surrounding lower right-sided sacral nerve roots.

So what do y'all think? I seriously DO NOT want any more surgeries.
I'm so nervous about what the surgeon is going to say. He wasn't very friendly with me and made me agree to certain terms if he was going to help me. Stop smoking, see a PT at least once and get the MRI before I saw him again on the 25th.

Edited to add laminectomy

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[QUOTE=teteri66;5414258]There is linear scarring within the L5-S1 thecal sac, with peripheral
displacement of the nerve roots at this level. Loculated adhesions are
also present at the S1 level , possibly associated with an intrathecal
CSF loculation, versus perineural cysts at the right S1 level. This
results in mild mass effect of the traversing lower right-sided sacral
nerve roots.

I take this to mean that there is scar tissue pressing on the sacral nerve roots on the right side at the S1 level that may be one of two things...a perineural cyst or it might be CSF (cerebral spinal fluid) that has leaked out of the canal and formed little pockets or chambers in the intrathecal space...but definitely ask the doctor![/QUOTE]

I sure hope he is in a good mood, because I'm writing my list. I really appreciate the help with what to ask. It's my right side that's the worst but it gets painful on the left side as well. I can feel like a squishy area on my right "hip" lower back where the pain is. I stopped trying to use my heating pad on my lower back because I think it was making me worse. I "slept" (awake every couple hours to adjust) with a pillow under my lower back and it seemed to help some. I didn't have the electric pulse running up my back last night but the cramps in my thighs and calves about drove me nuts. I ended up taking two flexerils just to fall asleep the first time. I wonder if I should be looking into a PM doctor? I guess that's another question to add.





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