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Previous Back surgery with new problem

Started by fyrdawg on 09/28/2010 1:09pm

Thank you in advance of reading my discussion!

I was injured at work lifting in 2001. Diagnosed as having a lumber strain, my MRI results were as follows: Vertebral bodies have normal shape and signal intensity.
The intervertebral discs have normal height and signal intensity.
At the L4-5 disc level there is a focal herniated nucleus pulposis to the left of midline. This is producing compression of the area of the nerve root and the neural foramen.
There is no compression on the thecal sac.
There is no significant degree of spinal stenosis.

I went through months of therapy, medication, and epidural injection, then laminectomy in 2002. Back to work months later, surgery was a great success! Very low occurence of discomfort/pain in the lower back, mostly pain/discomfort free.

No issues until reinjured back in August,immediate onset of lumbar pain, felt exactly like pain from previous injury in 2002. Was evaluated, MRI ordered, results: T2 images show slight levoscoliosis.
Sagittal T1-weighted scans show mild degenerative changes. The disc spaces are well-maintained.
Sagittal T2-weighted scans show normal conus terminating at the L1 level. There is early degeneration of the L2-L3 to L4-L5 discs.
The L1-L2 disc level shows a 1mm disc bulge.
The L2-L3 disc level shows a 2mm disc bulge. There is mild canal narrowing.
The L3-L4 level shows a 1 to 2 mm disc bulge.
The L4-L5 level shows a 4 mm retrolisthesis of L4-L5 There is a partial laminectomy off to the left and decreased epidural fat along the left side of the thecal sac and surrounding the left L5 nerve root. There is a 2 1 to 2 mm soft tissue at this level.
The L5-S1 level shows mild facet arthrosis. There is a 1 mm disc bulge at this level.
Following intravenous injection of 20 cc or Optimark, T1 weighted scans were obtained in three planes. On axial scans, there is enhancement in the left paramedian position at the L4-L5 level consistent with epidural fibrosis. This surrounds the left L5 nerve root.
My Doctor states that the "MRI looks good", that "there are no significant changes", and "no issues". I am no Dr, but I believe my MRI results are different than the results from 2001. I am in pain most of the day, with little relief from medication. I have sciatic issues this time(No sciatica in 2001), and I cannot sit or stand for an extended period of time without increased pain.
Should I be concerned? My doctor is trying to line up a surgical consult, but states there will be no need for surgery, maybe nerve blocks and therapy.
If anyone can translate the medical terms, and maybe give me an opinion, I would greatly appreciate it! I am particularly interested in my last MRI, is it as benign as I'm being told is?


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5 Responses


nothing major but a few minor problems like small disc bulges and some scar tissue near where they operated before. maybe its the scar tissue causing pain at L5/S1. ask about getting a shot down there. sometimes small problems on mri can cause big time pain. by checking where the pain is they may be able to pinpoint source of the problem.....good luck....pete


Thanks Pete for taking the time!

My issue is the fact that my current Dr believes that the MRI is clean and doesn't show any problems. I realize a 1 or 2 mm bulge is not huge, but they are bulging none the less. The other worrysome thing for me is I am on Ultram ER, Norflex, Mobic, and Vicoden 750s and have little to no relief of pain.
Unlike many, I love my job! and want to get back to it sooner rather than later! I want definitive treatment.
Take care!


my guess is that your trouble is at l4/l5....i missed the pressure on the neural foramen that they mention in 2nd paragraph.it is pressing on the nerve root but they dont say which root. this is far from normal. it causes pain!!!! the nerves there branch off from the spinal cord. are you having leg pain on one side?


ABSOLUTELY! I did not have sciatica in 2001, but I definately have all the classic signs and symptoms this time around...another reason why I went to get checked out.


Hi. I am recovering from #5 and six over a 4 day period. they are the LAST susrgeries I hope to have. They are also more than I bargained for. HOWEVER... you play the hand that you are dealt.
It reads to me like you have a few BULGING.... not herniated or ruptured discs and you neer expected this. As they are ONLY bulging and thats a good thing, phyiotherapy and hot and cold will be doing you right.YOU need to ask around for another opinion.... get a list from workers comp... this IS a comp case is it not??? IF NOT.... WAIT NO LONGER. ALL A COMP ATTORNEY AND MOVE IT!!! Get it from your insurance carrier and have at it.
You need to pproach this head on and do the therapy and accupuncture. where are you living? State??? I am in NY on Long Island. let me know ok? I have good insight from a been- there- done- that,,, got the T-Shirt stuff. It looks like you will do well with the therapies and be aggressive in your care. BE INFORMED AND DONT JUST BELIEVE BECAUSE SHE/HE IS A .
get involved and think success. YOU WILL WIN. be confident and if you have the SLIGHTEST MISIVINGS ABOUT YOUR DOC.... MOVE AWAY. gET THE HELL OUT OF THAT PRACTICE AND ASK AROUND!!!!!!
gOOD LUCK.....