KRO1990ParticipantFebruary 11, 2019 at 10:16 pmPost count: 1
Thank Dr. Corenman for the knowledge you pass onto all of us in ansewering these questions.
I hope you will assist me with my own. I have been expericing ongoing pain fo the last 4 weeks regarding the lower Back and through the left leg into the ball of the foot. This is 8 weeks after having a l5/s1 lumbar hemilaminectomy microdiscectomy and rhizolysis of which my surgeon has said is nothing to be worrying about and I should be all good.
I have completed an mri yesturday and the report runs through as the following:-
Evidence of the previous above surgery with Pre and Post contrast MRI.
Evidence of previous surgery with ill defined hetergeneous enhancement at the left hemilaminectomy site in keeping with postoperative granulation tissue/fibrosis with enhancing granulation tissue/fibrosis seen in the left l5 later recess Left S1 Lateral recess to extent partially around the traversing left s1 nerve root.
minor left asymmetric Lg/s1 disc protrusion and annular fissure withou evidence of contact of the traversing s1 nerve roots. Prominet epidural fat is noted around the thecal sac at L5/s1 Level. Longitudinal Linear t1 hyperintensity extending along the posterior margin of the thecal sac suggests a fatty filum terminal. Position of the conus medullaris appears normal.
There appears to be incidental enhancement of the Left s1 nerve without thickening, which may be reactive in nature.
My reports conclusion reads the evidence of the above and then
Minor Left Asymmetric shallow broad-based disc protrusion at L5/S1 annular fissure with no evidence of associated neural compression, with post surgical granulation tissue/scar tissue at the left L5/S1 hemilaminectomy site and the left subarticular recess partially surrounding the traversing left S1 Nerve root. Contrast enhancement of the left s1 nerve may be reactie in nature. No evidence of neural compression otherwise within the lumbosacral spine with no epidural collection or post operative complication otherwise identified.
I am concerned regarding this as the pain I have is not receeding and the pain going from the calf into the foot has not been present before and my dr has said this is not much for concern and is just the recovery phase and typical pains associated with recovery and to continue with the physio.
Reading through this and understanding this should I have any concerns or is this indeed just apart of a recovering patient from surgery?
And if there are concerns what would be the next step to adjust these issues I guess?
Thank you so much for your knowledgeDonald Corenman, MD, DCModeratorFebruary 13, 2019 at 2:33 pmPost count: 6542
The radiologist notes “postoperative granulation tissue/fibrosis with enhancing granulation tissue/fibrosis seen in the left l5 later recess Left S1 Lateral recess to extent partially around the traversing left s1 nerve root”. Also; “Contrast enhancement of the left s1 nerve may be reactie in nature”.
These findings indicate scar tissue formation (which is to be expected) and radiculitis (direct inflammation of the nerve root itself) which is quite rare after a microdiscectomy surgery. This nerve inflammation will take a while to calm down and I recommend a course of oral steroids for any of my patients who come in with radiculitis.
Dr. CorenmanPLEASE 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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