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  • 14 months Post PILF L5 S1

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    Old 04-16-2016, 04:54 PM   #1
    Anj75
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    Join Date: Apr 2016
    Posts: 37
    Anj75 HB User
    14 months Post PILF L5 S1

    Hi Everyone. My name is Angela. I had a PILF Feb.5, 2015, before that epidural steroid injections and and epidural when I gave birth 21 years ago. I recently had Xrays and a MRI done to follow up and see why I am in so much pain and as a follow up after surgery. When I Google the results of my MRI Arachnoditis keeps coming up. I am due for a follow up on the 25th of this month. Any help would be greatly appreciated. I am only on Flexeril for spasms to help me sleep. No-one offers pain pills or nerve pills and I'm afraid to ask because I don't want them to think that I'm pill seeking. I will post both results. I'm really depressed because I really just want to be normal. I'm a plumber and it takes all I have to make it through the day.

    IMPRESSION:
    Posterior instrumentation L5-S1 with interbody implant. Grade two 1.5 cm
    L5-S1 anterolisthesis, unchanged between flexion and extension views.
    Minimal 2 mm grade 1 retrolisthesis L1-L2, unchanged between flexion and
    extension views.Possible pseudarthrosis right L5-S1.Right upper quadrant surgical clips.
    Lower lumbar spine facet arthrosis.Mild bilateral sacroiliac joint osteoporosis.

    RESULT: Examination:
    MRI of the lumbar spine without contrast

    Clinical Information:
    Low back pain. Status post prior surgery.

    Technique:
    Standard multiplanar, multisequence MRI of the lumbar spine without
    contrast

    Comparison:
    Plain radiograph of the lumbar spine dated 3/28/2016

    Findings:
    Postsurgical changes status post posterior segmental instrumentation and
    L5-S1 with bilateral pedicle screws and connecting rods. Status post
    laminectomies at L5 and S1. Postsurgical changes in the posterior soft
    tissues.

    There is a grade 2 anterolisthesis of L5 with respect to S1 measuring 8
    mm. Vertebral body heights are normal. Marrow signal is normal. The conus
    terminates at the T12-L1 level.

    There is linear scarring within the L5-S1 thecal sac, with peripheral
    displacement of the nerve roots at this level. Loculated adhesions are
    also present at the S1 level , possibly associated with an intrathecal
    CSF loculation, versus perineural cysts at the right S1 level. This
    results in mild mass effect of the traversing lower right-sided sacral
    nerve roots.

    There are 5 nonrib bearing lumbar type vertebral bodies with the L5
    vertebral body identified by the iliolumbar ligament lumbosacral angle.

    Vertebral body heights are normal. Marrow signal is normal.

    L1-L2: Spinal canal and neural foramina are patent.
    L2-L3: Spinal canal and neural foramina are patent.
    L3-L4: Spinal canal and neural foramina are patent. Mild bilateral facet
    arthropathy with small facet joint effusions.
    L4-L5: Small central disc protrusion. No significant associated spinal
    canal narrowing. Mild bilateral facet arthropathy without significant
    neural foraminal narrowing.
    L5-S1: Status post posterior decompression with dorsal displacement of
    the thecal sac. The dorsal margin of the thecal sac has a slightly
    tethered appearance and there is abrupt narrowing of the thecal sac at
    the L5-S1 level. Anterolisthesis results in mild bilateral neural
    foraminal narrowing, the evaluation of which is limited due to
    susceptibility artifact from hardware.

    IMPRESSION:
    1. Postsurgical changes status post laminectomy at L5 and S1 and
    posterior segmental fusion L5-S1. Grade 2 anterolisthesis L5 with respect
    to S1 measuring 8 mm.
    2. Postsurgical change in the thecal sac L5-S1 levels, with peripheral
    displacement of the nerve roots which may reflect scarring and sequela of
    arachnoiditis. CSF loculation due to scarring, versus perineural cyst,
    right S2 level, with resultant mild mass effect and displacement of the
    surrounding lower right-sided sacral nerve roots.

    So what do y'all think? I seriously DO NOT want any more surgeries.
    I'm so nervous about what the surgeon is going to say. He wasn't very friendly with me and made me agree to certain terms if he was going to help me. Stop smoking, see a PT at least once and get the MRI before I saw him again on the 25th.

     
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