[fdylan1212]

#26623

I am currently 5 months post op and got an MRI down with & with contrast cause I am having burning like pain in my legs and heaviness & nerve like aches and of electric impulses in my left running and up and down.
My feet get so numb I have not worn socks in 5 months. MRI came back with the following findings noted below and I am looking for a general idea if these general findings can be contributing to my own going symptoms.

At the L4/5 level, a residual broad lateralizing disc bulge with central and left paracentral broad annular fissures are present
suggesting the operative margin. Coupled with facet hypertrophy and a marginal osteophytic ridge, there is mildly improved mild
to moderate bilateral foraminal narrowing with contact with the exiting right and left L4 nerve root.
Interval laminectomy has been performed with decompression of the central canal and resection of the previously seen central to
left paracentral disc herniation. A small broad fluid collection is seen at the level of the laminectomy measuring 0.5 x 2.3 x 1.6 CM
(anterior-posterior by transverse by superior-inferior.), likely representing a postoperative seroma. There is no connection to the
thecal sac. A small amount of enhancing soft tissue suggesting granulation tissue is noted extending along the lateral margins of the
spinal canal just contacting the descending L5 nerve roots within the subarticular recesses (axial series 8 image 12).
At the L5/S1 level, there is a residual broad-based disc bulge eccentric to the right again noted with a smaller 4.5 mm residual/
recurrent central to left paracentral disc protrusion resulting in narrowing of the left subarticular recess and mild to moderate
right foraminal narrowing and near contact with the exiting right L5 nerve root and the descending left S1 nerve root. A possible
conjoined left-sided nerve root is suggested within the left subarticular recess, possibly S1 and S2. Mild indentation of the thecal
sac noted with mild left foraminal narrowing.
Right-sided laminectomy performed. Enhancing soft tissue suggesting granulation tissue is noted along the lateral margins of thespinal canal partially extending into the subarticular recesses with contact with the descending right and left S1 nerve root. (Axialseries 6 image 23).

The visualized thoracic cord, conus and terminal nerve roots maintains intact morphology and signal intensity.
There is no abnormal intradural, leptomeningeal or extradural enhancement.
The retroperitoneal structures are unremarkable.

IMPRESSION
1. L4/5 and L5/S1 level interbody fusion and posterior fixation.
2. Scoliosis.
3. Mild lumbar spondylosis with facet arthrosis.
4. Congenital narrowing of the spinal canal. Epidural lipomatosis.
5. Discogenic disease as above.
6. Of note: L4/5 level residual lateralizing disc bulge contributes to mild to moderate bilateral foraminal narrowing, improved.
7. L5/S1 level residual disc bulge noted eccentric to the right with a smaller residual/recurrent central to left paracentral disc
protrusion narrowing the left subarticular recesses and contribute to mild to moderate right foraminal narrowing.
8. L4 and L5 level laminectomy with partial decompression of the central canal noted.
9. Small fluid collection behind the laminectomy at the L4/5 levels suggests a postoperative seroma.
10. Soft tissue suggesting granulation tissue noted at the L4/5 and L5/S1 level extending into the subarticular recesses and
contacting the descending nerve roots.

[Donald Corenman, MD, DC]

#26628

So you are 5 months out from what sounds to be a TLIF at L4-5 and L5-S1. What were your original symptoms prior to surgery and what what the cause of these symptoms (the disorder or the reason for surgery)? What workup was performed prior to surgery (nerve blocks, epidurals, etc..) and what where the results? How have your symptoms changed since surgery? What has your surgeon discussed regarding your current progress?

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.

[fdylan1212]

#26629

I was hurt at work back in 2015. My first surgery was in Sept. of 2016 cause I had two herniated disks and had a diskomecty. Soon after my symptoms came back: numbness in feet, heaviness in legs, weakness in my left leg.
I had a follow up MRI in Dec. of 2016 and the discs re-herniated and had severe central stenosis. Since it is workers comp. these things take a while to workout. Before my fusion I continued with the symptoms and did physical therapy and did the epidural shoots but they do not work. I just had a follow up with my surgeon and he wants me to go to pain management. He said that there was nothing wrong in my MRI’s to be feeling this way currently and I decided to have the images re-looked at and this report is what they sent me. Currently having electric like impulses in my legs and burning sensations in legs which I never had. So, I am not sure what to make of why current situation.

[Donald Corenman, MD, DC]

#26641

You need to be specific regarding original and current symptoms. See https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-neck-shoulder-and-arm-pain/ to understand how to describe symptoms accurately.

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.

[fdylan1212]

#26643

Before my 1st surgery when I got hurt I had back/rear end pain and sciatica & numbness in my left leg.
EMG test om my left leg showed chronic sciatica and weakness in my foot and calf
Most activities would upset the symptoms and laying down would make it better
My pain intervals were between a 9 & 10.

After my first surgery I felt a little better for a first few weeks but my symptoms came back gradually like the ones noted above and my right foot started to feel numb for the first time. Most activities would upset it and PT was not doing much. The pain started at a 5 in the morning and then 8 by days end. Between Jan and June of this year My right started to get worse and heaviness and numbness and nerve pain was bilateral.

Now, after the fusion my back pain was around a 8 and moderate numbness and heaviness in my legs and feet and then gradually got back into the bilateral leg pain, complete numbness and heaviness in left foot and my right leg and foot started shortly after. I also have massive weakness in my left foot and walk with a gait.
Burning sensations started in my legs along with electric impulses in my left leg just two months ago
I went to my MD and he reviewed my MRI’s and said there was no nerve compression and everything was healing.Now, wants me to go for pain management. So, while I await for my Pain appointment I had the MRI’s reevaluated and the report noted above is the findings.

[Donald Corenman, MD, DC]

#26646

So you initially had herniated discs causing left leg radiculopathy (“sciatica & numbness in my left leg, weakness in my foot and calf”). You don’t note if the weakness improved.

You then had the TLIFs but don’t note the reason for this surgery. Was it for recurrent herniation, foraminal collapse, isolated disc resorption or ???????

You also note “I also have massive weakness in my left foot and walk with a gait-(antalgic?). Does this mean the weakness never improved, became worse or improved but not much?

The radiologist noted “L4/5 level residual lateralizing disc bulge contributes to mild to moderate bilateral foraminal narrowing, improved. L5/S1 level residual disc bulge noted eccentric to the right with a smaller residual/recurrent central to left paracentral disc protrusion narrowing the left subarticular recesses and contribute to mild to moderate right foraminal narrowing”.

This means you have continued nerve compression but I can’t tell how much as these films need to be carefully screened and a careful history and physical examination needs to be completed. You need to see an experienced spine surgeon who will take the time to figure out what is going on and if there is any solution to your current state of affairs.

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.

[Author]

Posts