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    Old 02-21-2013, 03:26 AM   #1
    truckerbill
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    ct scan

    transspedicular internal fixation screws and interconnecting rods are again seen bilaterally at l4-l5 and the upper sacrum. there is also a posterior osseous fusion bilaterally. anterior interbody fusion caes are seen with osseous fusion material extending between the l4 l5 and l5-s1 endplates that appear to represent a contiguous osseous fusion mass. streak artifact related to the metallic devices obscures a majority of the spinal canal from l4 thruogh the upper sacrum.

    at l3-l4, there is a diffuse disc bulge and degenerative facet arthropathy. this appears to create mild-- moderate central spinal stenosis similar to the prior mri. the neural canals apper patent. there is no disc herniation seen.

    at l2-l3 and l1-l2 there is no disc bulge,herniation,central spinal or neural canal stenosis.

    otherwise the osseous structures demonstrate relatively normal trabecular pattern without lytic,blastic or destructive osseous change.

    trying to understand the finding but i am confused any help. thanks

     
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    Old 02-21-2013, 12:08 PM   #2
    pebblebeach3
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    Re: ct scan

    From the report it first appears that you have been thru prior spine surgery involving fusions and instrumentation planted in your spine.

    It appears that they could not read a lot because of all the instrumentation that was previously implanted from the prior surgeries. This is not uncommon that when instrumentation is used they cannot get clear pictures of the spine because of all that was implanted it obstructs getting a clear view of the spine.

    I have instrumentation in the cervical/thoracic region and the lumbar region and either I can not get any readings at all or a limited amout of reading.

    I know you had a CT scan I don't know if you will get better results using an MRI with or without contrast. It is worth asking to see if have a chance of getting a better reading on the films.

    It appears that there is some form of arthritis and bulge from what they are able to read. Herniations tend to be worse then BULGES. But that is not meant to say that bulges cannot cause you some issues. It also says "degenerative' meaning that what is occurring is something that will normally occur over time with the aging process. The normal adult will have some degree of "degeneration" within their spine.

    It does indicated that there is "moderate" spinal stenosis meaning that there is a "narrowing" on the spinal canal, thus putting pressure on the nerves. Stenosis can occur in the central spinal canal that carries all of the nerves that go thru the body then stenosis can occur at various levels of the spine where the nerves "exit" from the spine.

    The question is whether the stenosis is severe enough that it is causing damage or symptoms to the spine.

    What type of symptoms are you getting? Radiating pain? Pins & needles? Any limitation on what you could do before or what you can do now?

    Who ordered the CT scan? I would suggest seeing an orthopedist or a neurosurgeon for evaluation of the CT scan and an examination on what should be done whether it is in the form of medication or physical therapy or if surgery is an option somewhere in the future.

    Good luck let us know how you make out.

     
    Old 02-21-2013, 05:31 PM   #3
    teteri66
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    Re: ct scan

    truckerbill, You are a man of few words.

    I went back through your old posts and here is what I have concluded. You had surgery and I am gathering you are still in pain as you asked about failed back surgery syndrome....

    Your CT scan is very similar to the MRI you asked about in Nov. 2012. I don't think it is showing anything "new."

    If I had to guess, I think your pain is coming from the nerve clumping at L4-L5 that was mentioned on the MRI. Did you ever see a specialist about this, specifically asking about "archnoiditis?"

    The surgeon who did your surgery may not be the best person to ask about this problem. It can be difficult to get a diagnosis for arachnoiditis. At this time, there is no cure for it. Patients have to cope with pain management.

    Otherwise the CT scan indicates that the fusion appears to have taken place. At L3-L4 there is a disc bulge and the facet joint at this level has enlarged. These two issues contribute to the narrowing of the central canal, a disease process called stenosis. As there is less room for the nerves to function normally, stenosis often results in nerve pain.

     
    Old 02-27-2013, 07:36 AM   #4
    truckerbill
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    Re: ct scan

    findingsostoperative chages at L4-L5-S1 with susceptibility artifact from orthopedic hardware. degeneration of the L5-S1 disc noted. no significant spondylolisthesis. conus medullaris appears unremarkable.

    1: L1-2 andL2-3 levels show mild facet arthropathy.

    2:L3-4 spinal stenosis grossly unchanged. moderate facet arthropathy with fluid in the right facet joint. irregularity of the inferior aspect of the spinous process, consistent with prior fracture and/or postoperative changes has less abnormal signal and enhancement. resolution of the edema in this region, now with a sliver of curvilinear area of increased signal,consistent with fluid in the region between the osseous fragments.

    3:L4-5 postoperative chages. asymmetric clumping of the nerve roots.posterior arthropthy. narrowing of the thecal sac posterior to the superior aspect of L4 appears unchanged. slight increased truncation of the right anterolateral thecal sac posterior to the inferior aspect of L5 suspected. posterior enhancement and abnormal signal appear less prominent,likly postoperative. right foraminal narrowing L4-5 unchaged.

    4:L5-S1 postoperative chages with laminectomy. cystic areas adjacent to the left facet joint/orthopedic hardware have decreased in size. right foraminal narrowing/stenosis,grossly unchanged.
    got report back rom dr that did operation and he says the pain, tingling,numbness and butt and foot pain are not caused by the laminectomy,and i think he is full of it.

     
    Old 03-09-2013, 03:40 AM   #5
    truckerbill
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    Re: ct scan

    i went back to the dr that did the operation,and he is saying the fusion did not take,so he wants me to do a si joint inj. and hardware inj. what are the inj.going to prove.

     
    Old 03-09-2013, 09:39 AM   #6
    teteri66
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    Re: ct scan

    Hi,

    He is trying to figure out what is causing the symptoms you are experiencing. They will be a type of nerve block that should either confirm whether or not the hardware is causing pain or whether the SI joints are the responsible source.

     
    Old 03-09-2013, 05:01 PM   #7
    egp292
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    Re: ct scan

    Quote:
    Originally Posted by truckerbill View Post
    i went back to the dr that did the operation,and he is saying the fusion did not take,so he wants me to do a si joint inj. and hardware inj. what are the inj.going to prove.
    Sounds like a Discogram is in order. If TB still has pain, it could be discogenic from upper discs. That's what changed the tune of my surgeon, as he claimed my pain was facets and I did three sets of injections and then told him, "I'm not wasting another day vacation day from work for these stupid injections as they are not working! He ordered A DISCOGRAM and low and behold, he found the source of my pain.

    Just like you, MRI and CT was blinded by previously installed hardware, but going back to the CT with the dye injected from the Discogram, showed the leaks and found, without a doubt, where the source of my pain is.

    Suck it up and get a Discogram. Yes they hurt like hell but, you can get injections all year long until you run out of facets - then what?

     
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