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Back Problems Message Board


Back Problems Board Index


hello all,
it has now been 41/2 sicne my l5-s1 microdiscectomy still severe pain in right leg aswell severe back pain got my post op mri and here are my findings .........

recurrent or resundiual central dis herniation at l5-s1 lvl, with increased narrowing of the spinal canal , but without neural forminal narrowing
overall congenital narrowing of the spinal canal.

no intradural or extradural mass lesions,bone marrow sgnal intesity is normal,postsurgical changes are noted ,a hemangioma is noted within the left posterior aspect of the l3 vertebral body . there is overall congenital narrowing of the spinal canal

LEVEL SPECIFIC DEGENERATIVE CHANGES ARE DESCRIBED BELOW:
l4-l5 there is a broad based disc bulge with increased signal noted most consistent with an annular fissure . mild dilateral facet degenertave changes noted, the neural foramina are patent.

l5-s1 there is moderate recurrent or residual central disc hernation postsurgical changes are noted . there is decreased T2 signal within the intervertebral disc . ther is increased spinal canal narrowing above the already congenitally narrowed canal, without neural foraminal narrowing . there is scar tissue with possible mass effect on the transversing s1 nerve root mild billateral facet degenerative changes are noted.......


finally got an appointment with him last week and he mentioned "post laminectomy syndrome " i aske him what its that and he says its nothing dont worry about it ,then he says ssomething about epidoral fibrosis and say no big deal ..... finallly i ask him him what all this means on my mri and his responses is" well its not a huge deal and i want the radiologist to point out his findings because cause i dont see them " he is a ortho spine surgeon ...so he perscribes ne a medrol dosepak 9 days after ESI injection after taking dosepak was in severe pain went to my primary care doctor and she prescribes vicodin and put a referal in for a second opion with nuerosurgery and send me on my way

Im just so frustrated and im in exterme pain everyday its between a 7-9 dont have the urge to do things i used to love to do its reaking havoc on my marrige and personal life also no sex drive carrer drive nothing JUST HAD ENOUGH! ......PLEASE SOMEONE HELP WITH SOME KIND OF ANSWERS

THANKS>>>>>>>>> TOM:confused:
I'm sorry but I don't know if you meant your surgery was 4 1/2 weeks, months or years ago...This really makes a difference so please clarify!!

For the purposes of what I am about to write, I am going to assume you are 4.5 months out from your surgery.

To quickly answer the questions raised in your title: "Post laminectomy syndrome" is a term some doctors use to describe a situation where a patient has had a back surgery and is still in pain after the procedure. It is sometimes called Failed Back Surgery Syndrome. Both are misnomers, because the surgery hasn't really failed, and it isn't a syndrome. It refers to chronic pain in the back and/or leg after a surgical procedure on the spine. As far as any of the surgeons I've consulted with believe, it would be inappropriate to call your situation by that name this early in your recovery. Surgeons usually wait about a year before deciding a surgery has not been successful.

Epidural fibrosis refers to scar tissue that forms after a surgical procedure, not topically but inside the body where something has been cut or removed. We all form scar tissue any time the skin is cut. Some people have a problem with the scar tissue attaching to a nerve or another organ as it forms. It can result in pain for the patient, or nerve compression in some cases.

Obviously none of us are trained medical professionals, so take whatever you read here with that in mind! I don't know what your previous MRI indicated, but this report indicates some things that may or may not have occurred since your surgery. You may have reherniated the L5-S1 disc, as the report indicates there is still a central disc herniation at this level. Scar tissue is noted on the traversing S1 nerve root -- this is something that could be causing pain...as could the herniated disc. There are changes in the facet joints at this level and it is noted that your central canal is not as wide as it might be. Since the nerves have to pass through this space, if it is too narrow, it too can cause nerve compression...which results in a "sciatic-type" pain that radiates down the hip, leg and into the foot.

There are also some issues at the next level up, L4-5...including a disc herniation that may include an annular tear, and again, the facet joints are showing some degenerative changes. The facet joints are the moveable parts of the spine that allow us to bend forward, backward and to twist to the side...just like any other joint in the body, they can develop an arthritic condition, can enlarge, deteriorate and cause problems....

This is a very quick and dirty explanation of some of the issues brought up in your radiology report. I think your surgeon is downplaying some of the issues that are probably responsible for the pain you are experiencing. These may not be "big things" in the grand scheme of what all can be wrong with a spine...but they are certainly enough to cause you a great deal of pain.

The Medrol pack was prescribed in an attempt to settle the inflammation that is contributing to the pain. I would guess that most of your pain is coming from spinal nerves, so vicodin is not necessarily going to help...but it may take the edge off. I think it is a good idea to consult with another surgeon. He/she may have some ideas to help you in your recovery, or may have a different diagnosis for you.

Hang in there! Sometimes the recovery can be every bit as complicated as everything that came before the surgery.....:eek:





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