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Old 01-23-2013, 01:32 PM   #1
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please help... started hurting again after laminectomy jun 2011

Sorry if this is a duplicate thread but I posted one about 4 hours ago and I am not positive it went through...
Hi I had an emergency laminectomy June 2011 and now I am having more issues. I did not get to choose the dr and only had one follow up exam and nothing more with that surgery. Now I believe my new Dr (who is an amazing surgeon)forgets who I am in between visits and tells me something different every time. This time he said he could not figure out why I am having so much pain over a small bulge. Can you please help me interpret my last MRI (after my laminectomy) that was done in Aug 2012. I believe this is more than a small bulge and he has maybe mixed me up with another patient? Am I being a wimp or could these thing be causing my back pain? He has scheduled me a nerve test for feb 1. Also do you know what high intensity zone means? Thank you so much in advance for any insight.


Tll-Tl2,T12-LI andLl-L2 Level: No signihcant disc bulge is seen. The spinal canal and nerve root
foramen appear widely patent.
L2-L3 Level:5 mm posterior disc protrusion with a high-intensity zone. This does not narrow the spinal
canal or nerve root foramen.
L3-L4 Level: 3 mm posterior disc protrusion with a high-intensity zone. This does not narrow the spinal
canal or nerye root foramen.
L4-L5 Level: Postsurgical changes consisting of a right L4 laminectomy. There is enhancing scar tissue at
the laminectomy site and around the right L5 nerve root in the right lateral recess. There is a 4 mm right
paracentral enhancing disc extrusion which contacts the right L5 nerve root in the right lateral and displaces
it towards the facet joint. There is no signihcant stenosis of the spinal canal. There is mild narrowing of the
nerve root foramen.
L5-Sl Level: No significant disc bulge is seen. The spinal canal and nerve root foramen appear widely
patent.
There is no paraspinous mass or intradural mass. The conus medullaris ends at the level of T12-L1 and appears unremarkable.

Impression:
I . Postsurgical changes at the L4-L5 level consisting of a right L4 laminectomy. There appears to be a
residual recurrent right paracentral disc extrusion which results in mild to moderate stenosis of the right
lateral recess, displaiing the right L5 nerve root against the facet joint. The right L5 nerve root may be
compromised to some degree and clinical correlation regarding right L5 radiculopathy is recommended.
2. Posterior disc protrusions at the L2-L3 andl3-L4 levels without significant spinal stenosis.

Sorry for any mispelling/typos adobe reader did not pull all of the information over correctly for some reason!

 
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Old 01-23-2013, 03:59 PM   #2
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Re: please help.. started hurting again after laminectomy jun 2011

Why do you think this new doctor is so "amazing"? In the next sentence you question whether he keeps mixing you up with other patients...this doesn't sound too reassuring!

The reason you are being sent for the EMG is to check for radiculopathy of the L5 nerve. You have several issues going on at the level of the previous laminectomy and is probaby causing the pain symptoms you are having. The MRI raises the possibility that this nerve is being compressed and there is the suggestion to check this out further...which will be done with the EMG.

There are small disc bulges at L2-L3 and L3-L4 which do not cause stenosis of the central canal or the foramen. These are noted but are likely not causing any symptoms of pain.

The high intensity zone is radiological language for a finding on a T2-weighted MRI image that signals the possibility of an annular tear in the lumbar disc. Technically it is the way the tissue shows up on the image. (It looks different that the surrounding tissue--it stands out--)

[B]L4-L5 Level: Postsurgical changes consisting of a right L4 laminectomy. There is enhancing scar tissue at the laminectomy site and around the right L5 nerve root in the right lateral recess. There is a 4 mm right paracentral enhancing disc extrusion which contacts the right L5 nerve root in the right lateral and displaces it towards the facet joint. There is no signihcant stenosis of the spinal canal. There is mild narrowing of the nerve root foramen.[/B]

The reporter states there are changes at this level that are a result of a laminectomy that was performed on the right side. There appears to be scar tissue in this area that extends to the L5 nerve root as it goes through the right lateral recess.

In addition there is a 4 mm disc extrusion to the right of center that is coming in contact with that right L5 nerve root and is pushing the nerve toward the facet joint on this side. There is a small amount of stenosis in the foramen, but the central canal has no significant amount of stenosis.

The reporter believes the right L5 nerve root may be suffering due to these problems...it may be compressed as a result of the stenosis, or it may just be irritated.

If I failed to define a term you aren't clear about, please let me know.

 
Old 01-23-2013, 05:04 PM   #3
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Re: please help.. started hurting again after laminectomy jun 2011

Hi sdchic, I wanted you to know im so sorry that this is happening, i also had this happen after first laminectomy. Had lum lam @ L4-5, L5-S1 & reherniated the disc, i had surgery again. I remember the pain & i waited & waited for it to get better to no avail. I understand & hope that you find the right treatment for you. It will get better, please keep us updated on your progress, ok? Thanks

 
Old 01-24-2013, 07:44 AM   #4
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Re: please help.. started hurting again after laminectomy jun 2011

Thank you so much. That makes sense but the dr is just sending me for the test to see if there is any nerve damage per what he says i have nothing pressing a nerve. That is why i think he may have had me confused? The reason I say he is an amazing surgeon I have had multie family members that he has had to work on and friends that have had surgeries before with no relief until him (literally 6 people I know 2 of which family). Thank you again for the breakdown. Do you know if the tears hurt that bad? I do ALOT of bending at work (sometimes 6 hours straight or more) so I am worried this may keep re injuring my back :-( and why I am still havi y a lot of trouble. Like I stated before I did not have any guidance after my first surgery because I was not a patient of the dr who performed it and I probably should not have been realeased a month later to full duty. I wish I would have pt and known the right and wrong things to do like I do now after reading them on here. Once again thank you!

 
Old 01-24-2013, 07:47 AM   #5
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Re: please help.. started hurting again after laminectomy jun 2011

[QUOTE=gmak;5121962]Hi sdchic, I wanted you to know im so sorry that this is happening, i also had this happen after first laminectomy. Had lum lam @ L4-5, L5-S1 & reherniated the disc, i had surgery again. I remember the pain & i waited & waited for it to get better to no avail. I understand & hope that you find the right treatment for you. It will get better, please keep us updated on your progress, ok? Thanks[/QUOTE]

Thank you so much! Just ready to feel normal (well as close as I can) with less pain. It just feels like I cant even walk down the mall after 20 minutes I just want to get the weight off my back. and work oh man on our breaks I literally lay in the floor just to get the weight off. But thank you so much for your sweet comments! Have a great day!

 
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