glo

Hello Dr Corenmann,
thanks for your reply. here is the operative report from the surgeon:
We place a right iliac stealth pin and arc and did intraop oarm ct and registered stealth navigation system. We use stealth to localize the 2 MIS wiltse plane incisions and created a 1 inch incision over the bilateral L4-5 pedicales.(BUT MY FINAL INCISIONS ARE 2.5″ EACH SIDE). We used stealth as she had very abnormaly angulated L4-5 pedicales and we navigated with a cannulated drill and created L4-5 pilot holes and placed kwires and tapped and placed L4-5 pedicle screws bilaterally (left L4 screw we placed after the TLIF to avoid hindering the TLIF view). We used cannulated cortical fix expendium pedical screws as she is osteoporotic. The left L4 screw purchase was not as solid as the right L4 or bilateral L5 screws. The inferior L4 pedicle was weak and eroded when we placed that screw due to osteoporosis. However, we inspected the exiting nerve root and the screw was not touching it so we left the screw in place. We did a left L4-5 facetectomy and laminotomy and decompressed the exiting and traversing roots using microscope and microdissection techniques. We had a small dural tear on the left L4-5 lateral dura and repaired this with microsope and micro sulture w 6-0 prolene and a small muscle autograft. We placed duraseal over this repair. We did L4-5 discectomy from left and interbody arthrodesis and cage placement with globus cage and placed local autograft and iliac bone marrow aspirate autograft and mosaic graft extender into L4-5 disc space to complete the transforaminal interbody fusion. We expanded the TLIF cage to get sold purchase. We connected rods to the screw heads and locked the locking screws and placed right sided posterolateral arthrodesis w local bone graft into the L4-5 facet. Hemostasis was achieved with bipolar. The wound was closed in a layered fashion. I was present for all key portions of the procedure. I did the decompression via microscope and hardware placement w navigation myself. The sponge and needle counts were correct per the nursing staff.

Sorry being so long.
Did it sound like the surgeon did all the work, I was told he has his fellow assisting and she did the closing of the incision. They have to sultured it with graft and duraseal glue–would it still be pinhole or large/spaghetti??

I really want an MRI ASAP! The earliest I can ask for one is at my 6 months post-op in late April. Do I need one with contrast since I have hardware in the spine? Would you think I can see a neurologist for EMG and request him to order an MRI? Would you order an MRI for me if I request a remote consultation with you? Please advise.

thanks again for all your help and advices.
best regards,
glo