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#32604

Dr. Corenman,

Here are the results from my MRI taken May 27, 2020, the surgeon said that the MRI is showing everything looks good and that sometimes the nerve just takes a longtime to heal and continue PT…I continue to be in pain daily wondering if this nerve will ever heal. I am two and half months post-surgery, he says it still early in the recovery process. My MRI results are;
Examination: MRI LUMBAR SPINE W/WO
Indication: BACK PAIN, LOW. L4-5 microdiscectomy 3/17/2020
Technique: MRI lumbar spine without and with intravenous contrast.
Comparison: Lumbar spine MRI 2/18/2020
Findings: At L3-4, there is a mild disc bulge and superimposed left foraminal disc protrusion. No spinal canal or foraminal stenosis.
At L4-5 there are postoperative changes on the left from recent discectomy. There is enhancing granulation tissue in the left epidural space surrounding the left L5 nerve root sheath. No recurrent disc herniation is appreciated.There is no spinal canal or neural foraminal stenosis. There is a minimal 5 mm fluid collection at the laminotomy site. There is slightly increased size of a mild Schmorl’s node of the L5 superior endplat with mildly increased adjacent Modic type I endplate Change.
At L5-S1 there is an unchanged mild disc bulge. There are intraforaminal and far lateral disc osteophyte complexes bilaterally. There is moderate/severe right foraminal stenosis. No left foraminal stenosis.
There is T2 STIR hyperintense edema of the left paraspinal muscles which are beginning at L5 through visualized sacrum.
Impression:
Postoperative changes at L4-5. No recurrent disc herniation appreciated.

[wave7]

#32605

Dr. Corenman,

I posted my MRI results in my last post, my surgeon has released me, but my pain is still the same….My surgeon says it is still early in the recovery process but i am so worried. What is the next step in trying to resolve this nerve pain?

[Donald Corenman, MD, DC]

#32610

According to the radiologist, there is no recurrent herniation but it sounds like significant inflammation (“There is enhancing granulation tissue in the left epidural space surrounding the left L5 nerve root sheath”). There is also a small collection of fluid but the reading doesn’t say that this is compressive. If your pain has not improved, I would consider an epidural steroid injection but get some labs to make sure you don’t have a low grade infection. The injectionist can order those labs and if negative, then the injection can be considered.

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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