[Thecarter]

#28326

Dr, an update, from my MRI with contrast findings. If you could please explain the following, I’d be very appreciative :

T12/L1, L1/2, L2/3 and L3/4 disc spaces are preserved.
L4/5: Status post left L4/5 laminectomy. There is mild symmetrical circumferential disc
bulge with a small central disc protrusion indenting the anterior thecal sac as before. The
degree of subarticular zone stenosis previously identified has improved. There is no spinal
canal stenosis. The AP diameter of the CSF space is widely patent measuring 1.4 cm. In
the left laminectomy bed, there is mild enhancement which demonstrate intermediate T2
signal is suggestive of scarring and fibrosis. No discrete fluid collection. There is minimal
mass effect of the dorsal left thecal sac but the spinal canal remains patent. No mass effect
on the nerve roots. No significant abnormal epidural enhancement.
L5/S1: There is metallic susceptibility artifact seen in the posterior aspect of the L5/S1 soft
tissue. Note is made of L5/S1 laminectomy and discectomy. The previously seen left
paracentral herniated disc and extrusion has completely resected. There is mild to
moderate posterior disc height loss. There is persistent very mild central broad based disc
protrusion indenting the anterior thecal sac but no spinal canal stenosis. The disc does not
appear to be contacting the spinal canal. The subarticular zones are also patent. There is
mild increased enhancement in the left epidural space in the surgical bed but there is no spinal canal stenosis. Mild enhancement of the left facet joint is also identified but no
significant joint effusion. Minimal enhancement is seen in the posterior subcutaneous fat
and posterior to the spinous processes at L5/S1 level.
There is mild edema in the left paraspinal muscle in keeping with recent surgery. The rest
of the paravertebral soft tissue is within normal limits.
The conus medullaris terminates at L1 with normal signal intensity and morphology.
IMPRESSION:
1. The L5/S1 left paracentral disc protrusion and extruded disc has been resected. The
L5/S1 disc height is decreased, with very mild central broad based disc protrusion without
spinal canal stenosis or neural foraminal narrowing. There is mild enhancement in the left
posterior epidural without compressing the nerve roots.
2. L4/5 left laminectomy also identified. The previously seen mild to moderate lateral
recess stenosis has improved. There is moderate enhancement in the left laminectomy bed
suggestive of scarring. No large fluid collection identified. This does not impinge the nerve
roots nor cause spinal canal stenosis .

[Pebec]

#32445

Hi @Thecarter

I saw this post when searching on google.

I am 4 weeks postop microdiscectomy/laminectomy and also have a positive SLR.

It started 9 months ago with injury where main symptom was positive SLR but mainly in back. Then 5 months later I got really bad sciatica and got surgery after 4 additonal months.

Almost all pain is gone except for positive SLR (mostly feel in back/hip)

When did you achieve a negative SLR post surgery? What to expect? For me no improvement week on week

BR
Peter

[Donald Corenman, MD, DC]

#32446

Typically, the SLR (straight leg raise sign) calms down quickly but residual 10-20% of symptoms can take as long as 6 months to fade away.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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