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in reply to: Post Fusion- Leg #31137
Thanks doc , two more quick questions here.
1) when you refer to stretching of the nerve , do you mean that coughin can cause that stretch ?2) will a ESI affect the ability for the bones to fuse ?
in reply to: Post Fusion- Leg #31134Sorry doc last question, why do you think I still get pain down my leg (along the s1 nerve path, down the glute and back of hamstring) when I cough or sneeze. If there is no more disc and rods holding it in place shouldn’t this not happen? Or is the nerve so irritated that and sudden movement can make it angry .
Thanks always in advance
in reply to: Post Fusion- Leg #31131Yes , sorry – BMP and apologies for my spelling mistakes. They did give me a second medrol pack which I don’t want to take because of how it makes me feel. Hopefully this will go away over time and I think I am irritating it by sitting at work too long and getting up and down from lying on the couch. Thanks as always. If you have any other advice please let me know I appreciate what you do for everyone in confused and stressed out states.
in reply to: Post Fusion- Leg #31127Thanks Dr. he did you BMO but doesn’t want me to do a steroid yet. In your experience is this something that will just take awhile to heal ?
in reply to: Post Fusion- Leg #31115Pain has continued to get more severe in the left leg, here is my MRI from yesterday, could you help with reading this and your thoughts?
Exam: MRI Lumbar Spine Without and With Contrast
History: Prior spinal surgery most recent fusion on 8/12/2019- radiating pain
Technique: Coronal T2 weighted sagittal pre and post contrast T-1 weighted proton density and T2 weighted and axial pre and post contrast and T2 weighted images performed on a 1.5T unit
Contrast: 16ML dotarem from a 20ml vial
Comparison: Prior MRI exams most recent 6/4/2019Findings:
Alignment
Non specific straightening
Mild grade 1 retrolisthesis L5-S1
Vertebrae
Hernatopoietic marrow
No compression fracture deformity or pathological marrow infiltrative process
Underlying bony canal is capacious
Disc spaces:
L1-2 throughout l4-5 no disc bulge, herniation spinal or foraminal stenosis. Disc space heights are maintained and there is preservation of the normal intervertebral disc signalL5-S1- spinal instrumentation post discectomy Left-sided surgery including facetectomy/foraminotomy/laminectomy with a central left sided interbody fusion device. Mild deformity of the L5 inferior endplate. Minimally enhanced material extending from the central left side of the disc space with minimal deformity of the thecal sac, this could represent a combination of postsurgical change and disc. There is diffuse enhancement of the epidural space most significantly surrounding the left descending S1 nerve root and extending to the posterior disc oriented in the same plane as the interbody device, compatible with postsurgical enhancement. Bilateral L5-S1 pedicle screws and interconnecting rods with artifact. No central spinal stenosis. Foramina free of significant compromise. Mildly narrowed disc space with desiccation.
Intraspinal:
Conus medullaris is normal in appearance and terminates normally at L1-2
Subarachnoid space and cauda equina are unremarkable
Paraspinal
Aorta maintains its normal calber
No evidence of an anterior paraspinal mass
Non specific enhancement within the posterior paraspinal muscles at the surgical leveImpression:
Interval additional surgery L5-S1, instrumented spinal fusion post discectomy. Minimally enhanced material extending from the central left side of the disc space with minimal thecal sac deformity, currently no compression of the descending S1 nerve root, this likely represents a combination of disc and post surgical enhancement within the disc. Compared to the preoperative study, improved mass effect. No interval disc hernations at other lumbar levels.in reply to: Post Fusion- Leg #31094Thanks, I asked today and they want me to wait a few more days. Today is my 1 month anniversary.
What do you make of my leg pain/nerve pain down my legs when standing? I was always told it was because a disc was pressing above an inflamed nerve or it was because of stenosis which I should have neither of now.
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