[Sailormoon]

#33429

Hi Dr Corenman,

The previous MRI (before surgery for debridement) performed with contras and radiologist stated that:

– there is mass on corpus with infiltration to pre and paravertebral and especially invasion to intra spinal, infiltration to retrovertebral
– Spinal stenosis and compression to thecal sac, especially to S1 bilateral.

Do you know what it means? After surgery my doctor said there is so much pus near my dura, but not inside the spinal canal. On contrary with note from radiologist above right?

While he also said the nerve so sticky and cant differentiate between nerve and scar tissue, so he make them free from bone. I dont know which nerve mention by him, because he said he didnt enter spinal canal.

Is it too risky too perform debridement on spinal canal? If i have pus pocket there, does my CRP will high too?
If it is a phlegmon, does it will cause nerve deterioration? And how long it will cured?

My bowel movement now already full impacted. I cant sit here waiting for my bladder and motoric impacted too. I have gradual onset of cauda equina ????

I just go to other doctor to have other opinion and he said MRI after surgery doesnt represent real condition. He said its hard to differentiate between pus, scar tissue or else. So he suggest me to wait and heal the infection. I feel stuck.

[Donald Corenman, MD, DC]

#33430

I’m confused. This MRI reading you refer to issues from the period prior to your last debridement? We do not have new imaging information currently?

This is why gadolinium is helpful. If you have a mass that “fully lights up” with Gad, that generally indicates a phlegmon which can possibly be treated with antibiotics. If you have a mass that had a “dark void”, that can indicate an abscess where the antibiotic cannot penetrate and cure might not be possible (amoung other findings).

Your best friends right now are your hopefully declining labs (CRP, ESR and WBC), your symptoms (hopefully declining fevers, chills and sweats), your newest MRI findings and of course your IV antibiotics.

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.

[Sailormoon]

#33432

Hi Dr,

Sorry to make you feel confused. I just want to inform you that i had MRI contrast before, which is before surgery. But the radiologist and doctor read it as pus invasing my spinal canal, not something else, nor abscess.

After surgery, i had MRI too, non contrast. But the black shadow is wider compared to previous one.

My WBC and CRP now already normal, except my ESR is 40. Tomorrow i will have another blood check.

I have no fever, sweat or etc. I no longer have back pain. Physically im healthy.

All i have is nerve deterioration, i no longer have bowel movement, my foot become numb, reducing skin sensory. And bowel disturbance is new. I just had it few days ago. Considering my blood check relatively good, it should be not abscess, right?

[Sailormoon]

#33433

Dr,

I mean, the blood check is improve, the back pain is gone, but the black shadow on my spinal canal is wider.
And it aligned with my nerve deterioration symptoms.

If the infection is heals why the nerve deterioration become worst? Thats why i think i have other issue.

[Donald Corenman, MD, DC]

#33434

Nerves are sensitive structures and can be affected by infection. The nerves can be scarred and lose vascularity (blood flow) which can impair their function. You need to get on a bowel program to make sure you are not constipated.

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.

[Sailormoon]

#33435

Hi Dr,

Do you mean arachnoiditis?

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