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Old 03-05-2007, 03:05 PM   #1
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1 year post fusion, MRI question

I have been having major nerve pain in my leg AGAIN. I went last week and had an MRI done. He told me other than alot of scar tissue that could irritate the nerves, everything was "ok". Here is what the MRI shows:

At the L4-L5 level, with artifact from pedicle screws and rods evident. There appears to be a left laminotomy defect at L4. Central interbody prosthesis is suggested. No central canal or foraminal compromise evident.

At the L5-S1 level, there is no focal disc protrusion or extrusion demonstrated. Right pedical screw extends mildly anterolateral just outside of the anterior cortex of S1.

Findings: Patient is status post posterior fusion L4 through S1 via pedical screws and rods. Vertebral body heights maintained. Endplate degenerative signal changes noted at multiple levels, most pronounced at L4-L5. The conus demonstrates normal signal and morphology, tip identified at the L1 inferior endplate level. Schmorl's nodes at multiple levels most prominent at L1-L2 evident.

At the L3-L4 level, beginning disc desiccation is noted without focal disc protrusion or extrusion.

Maybe I am wrong, but this doesn't sound like scar tissue causing nerve pain flareups but I am unclear as to what it means. What is Schmorl's nodes?

I am trying to determine why the nerve pain is back with a vengence and is this something I might as well prepare myself to deal with the rest of my life.

Thanks!

Jami in TN

 
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Old 03-05-2007, 04:15 PM   #2
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Re: 1 year post fusion, MRI question

Schmorl's nodes are common with degeneration of the spine. Schmorl's nodes usually cause no symptoms, but reflect that "wear and tear" of the spine has occurred over time.

 
Old 03-05-2007, 04:36 PM   #3
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Re: 1 year post fusion, MRI question

Is there a reason that these nodes have never appeared before now? My last MRI on my back was in June 2006 just to make sure everything was healing since I was having "nerve flare ups" 4 months after my surgery. Does it mean the discs are deteriorating faster now?

Thanks for taking the time to respond. I hope you are staying off your feet and not sweeping any more lol I made the mistake of doing things after my surgery because I was tired of "resting". My back and the nerves waking up sure let me know this was NOT a nice thing to do to them lol

Have a great day!

Jami in TN

 
Old 03-05-2007, 04:49 PM   #4
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Re: 1 year post fusion, MRI question

Jami - I have no clue why it has not shown up prior. Sorry I wish that I could offer some words of wisdom.

Don't worry I am not sweeping EVER again!! LOL

 
Old 03-05-2007, 04:52 PM   #5
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Re: 1 year post fusion, MRI question

One thing I have noticed is that different radiologist tend to put more or less in their interpretation, especially when talking about stuff that is considered of low importance to the symptoms. Maybe you caught him on a slow day.

 
Old 03-05-2007, 05:44 PM   #6
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Re: 1 year post fusion, MRI question

You are right Jack. I got out the last MRI and compared it to this one to see if it was a different radiologist because they were done at the same imaging place. This radiologist was a female. I could be sexist and say maybe thats why more detail is given here but I will refrain lol

To add more to this situation, I had surgery on my neck in October to replace and fuse 3 discs. This MRI shows further complications with my neck as well *sigh* I only wish the spinal disorder board was as responsive as this board has been so I could understand what all is going on with my body. I am much to young to feel this damn old!!!

Thanks for pointing this out, it helps make more sense of what I am reading!

Jami in TN

 
Old 03-06-2007, 05:17 AM   #7
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Re: 1 year post fusion, MRI question

[COLOR="DarkSlateBlue"][B]
Hi,
Schmorl's nodes ? I believe there a cyst on the spine ,I got these to and think it's from when you had surgery , it has to do with blood or somthing..****** it up and find out for sure ,i did at one time but I can't remember it all. It's really nothing to worry about. Your MRI's seem normal for a person who had a fusion.

I always look stuff up on ****** when I want to know what it means. It's a big help..Hope your pain goes away.[/B][/COLOR]

 
Old 03-06-2007, 05:18 AM   #8
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Re: 1 year post fusion, MRI question

[QUOTE=shawley;2839670][COLOR="DarkSlateBlue"][B]
Hi,
Schmorl's nodes ? I believe there a cyst on the spine ,I got these to and think it's from when you had surgery , it has to do with blood or somthing..get on your computer and look it up and find out for sure ,i did at one time but I can't remember it all. It's really nothing to worry about. Your MRI's seem normal for a person who had a fusion.

I always look stuff up on my computer, when I want to know what it means. It's a big help..Hope your pain goes away.[/B][/COLOR][/QUOTE]

 
Old 03-06-2007, 10:26 AM   #9
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Re: 1 year post fusion, MRI question

[B]There appears to be a left laminotomy defect at L4. Central interbody prosthesis is suggested.[/B]

Does anyone know what this means? What is a laminotomy defect and what is a central interbody prosthesis they are recommending? I have tried to research it but not finding anything.

Thanks!

 
Old 03-06-2007, 10:28 AM   #10
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Re: 1 year post fusion, MRI question

[COLOR="Navy"][B]Sorry I took it they were talking about your fusion [/B][/COLOR][QUOTE=hugg724;2840341][B]There appears to be a left laminotomy defect at L4. Central interbody prosthesis is suggested.[/B]

Does anyone know what this means? What is a laminotomy defect and what is a central interbody prosthesis they are recommending? I have tried to research it but not finding anything.

Thanks![/QUOTE]

 
Old 03-06-2007, 10:49 AM   #11
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Re: 1 year post fusion, MRI question

This is one of the discs that were done. For some reason, I was thinking he used some type of artificial disc. He didn't use bone grafts from a cadaver on these two discs like he did in my neck. I guess my confusion is the terms "defect" and central prosthesis is suggested.

Are they saying something is wrong with that fusion? Why would a central prosthesis be suggested? Better yet, what exactly is a central prosthesis? lol

Thanks!

 
Old 03-06-2007, 11:31 AM   #12
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Re: 1 year post fusion, MRI question

Hi Hugg: Schmorls nodes are when the disc herniates vertically into the vertebra (bone) instead of out to the sides. Normally when we have a herniated disc, it bulges horizontally (to the left or right) but what they are referring to is vertical herniation. Central interbody prothesis is hardware insertion, which you already have, right? I'm not sure about the laminotomy defect, but when you have stenosis they can either do a laminectomy to relieve canal pressure or a laminotomy where a small portion of the lamina is removed to relieve nerve pressure. Did you have a laminotomy prior to the mri? If so this might explain the wording of laminotomy defect. I have stenosis, and both of these where done at different times.

Since your dr feels you are okay, I'm not sure how much of this you should think about, since most surgeons don't pay too much attention to the radiologists report anyway. I know my dr. will only look at the films.

Good Luck...

 
Old 03-06-2007, 06:11 PM   #13
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Re: 1 year post fusion, MRI question

Dear Jami in TN....I live in Clarksville, TN, about 40 miles from Nashville. Where did you have your surgery done?

Mine was done six months ago by Dr. Scott Standard, (NEUROLOGICAL SURGEONS) in Nashville. It was done at Baptist North Tower Surgical Hospital on Murphy Ave. I had an ALIF at the L4-5 level, and I am still experiencing a lot of nerve pain, etc. I am scheduled for an MRI, also, this Thurs., so I was interested in reading your post. I hope that you are doing better. I am so sorry to hear that you are not feeling as well as you hoped that you would.
How many years have you been having problems, and what have they been? Mine was caused by degenerative
disc disease.

Talk to you soon. Orchidflower

 
Old 03-06-2007, 06:35 PM   #14
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Re: 1 year post fusion, MRI question

Hi Orchidflower -

I had no prior warnings other than just a low back ache once in a while which I attributed to I am getting old and need to give up softball lol. I had walking pneumonia in July 2005 which was causing me to cough pretty hard. I had a coughing spell one night, the next morning when I went to get up, my leg gave out, the back pain was HORRIBLE and I hit the floor.

I went to the dr. and they chalked it up to I pulled a muscle from coughing so hard, gave me a steroid shot, some pain pills and told me take it easy for a couple weeks. A month went by and I was still hurting really bad so they did an MRI and referred me to Dr. Moran of Mid State Neurosurgery in Murfreesboro. I have had 3 surgerys at Middle TN Med Center. I started with a laminectomy in Sept 2006 and had further problems with that disc and then the one below it ruptured. Five months later (feb 2006), I had what I think was artificial disc replacement with pedical screws and rods to hold everything in place. After about six months, I was finally starting to feel a little better until the bad headaches and burning pain in my shoulder.

After another MRI, I found out that 2 discs in my neck were ruptured out of both sides and the way he explained it, a 3rd was basically gone and I had bone rubbing bone. There was also a bone spur formation that covered a 4 disc area so back to surgery I went in October for a 3 disc fusion. Not long after that, my back began aching again and after 2 severe nerve flare ups, they did an MRI on my back and wanted to check my neck while they were in there.

That brings me to where I am now.....with a majorly screwed up spine *sigh* I have degenerative disc disease as well. Mine just seems to have hit all at once and the surgery just seems to

I don't know what to do from here and its frustrating. He told me in 2 months he will be referring me to a pain clinic. Maybe a fresh set of eyes looking at my MRI that doesn't write everything off as "you had 2 major surgeries in an 8 month period and its all part of it" will be able to tell me something. I am at the point I would like a second opinion but not sure how to obtain that without "stepping on toes".

Good luck on your MRI! I am sending you positive MRI thoughts

Jami

p.s. want to go to the airport and see how many detectors we can set off? hehehehhehee

 
Old 03-06-2007, 07:04 PM   #15
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Re: 1 year post fusion, MRI question

Hi Neighbor!!

I flew to Houston last month to see our 23 yr. old daughter, and I could not believe that I did not set off the metal detectors....there goes our fun!!!!

Seriously, don't feel badly about getting a second opinion. I got a second opinion, when my first NS recommended fusion by opening up the front abdomen, doing the surgery there, closing me up, and then opening up my lumbar area to do the back surgery two weeks later. The NS who did my surgery did it all at one time, which made so much more sense to me and my husband.

I have been seeing a pain specialist for the last four years, and I am taking strong pain medication, which doesn't seem to be helping much, anymore. I had three epidural steroid injections, between december and january (THERE IS SOMETHING WRONG WITH MY COMPUTER...SORRY) through the pain management clinic and they helped somewhat

i will let you know what the results are for the mri...i will be thinking about you.

GOD BLESS ORCHID FLOWER

 
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