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MRI experts??

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Unread 11-14-2012, 09:10 PM   #1
Nacho34
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Default MRI experts??

I just had an MRI done yesterday nearly two years after my discectomy operation on l5/s1..... Been dealing with off and on pain since then but have muscled through it. No doc visits or narcotics prescribed but I finally had enough and went in. The doc was concerned about some results of the pin prick test so he had an MRI done and I'd like to know what it all means.... Below is the report.... If anyone can translate to normal people speak I'd love you forever. Also, do you think this will mean yet another surgery to fix this mess? TIA.

L3-4: interval development of a broad based disc protrusion producing thecal sac effacement greater to the left of midline.

L4-5: some loss in disc signal intensity. Some generalized bulging of the disc is greater to left producing mild diffuse thecal sac effacement.

L5-s1: some disc signal changes anterolateral to the thecal sac on the left are present and abut the traversing left s1 root and also abut the anterolateral aspect of the thecal sac on the left. Could be fibrosis or some extruded disc material....

Development of a schmorl's node involving the inferior end plate if l5 anteriorly

Thoughts new friends??
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Unread 11-14-2012, 11:07 PM   #2
Nacho34
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No amateur neurologists know what that means?? I'm 30, pretty healthy and I'm worried about having to do surgery again... Apparently my reflex and feeling in the right leg was non-existent or extremely muted at my appt... Considering that with the MRI report am I screwed?
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Unread 11-15-2012, 12:20 AM   #3
gatorhead
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Originally Posted by Nacho34 View Post
I just had an MRI done yesterday nearly two years after my discectomy operation on l5/s1..... Been dealing with off and on pain since then but have muscled through it. No doc visits or narcotics prescribed but I finally had enough and went in. The doc was concerned about some results of the pin prick test so he had an MRI done and I'd like to know what it all means.... Below is the report.... If anyone can translate to normal people speak I'd love you forever. Also, do you think this will mean yet another surgery to fix this mess? TIA.

L3-4: interval development of a broad based disc protrusion producing thecal sac effacement greater to the left of midline.
This is a disc herniation that goes into the cord area but is not touching the cord it is more to the left than to the center, but doesnt mention any foraminal narrowing. It also doesn't say how far it is extruded but from this I would deem it mild at worst.

L4-5: some loss in disc signal intensity. Some generalized bulging of the disc is greater to left producing mild diffuse thecal sac effacement.
Pretty much the same, probably a little less
L5-s1: some disc signal changes anterolateral to the thecal sac on the left are present and abut the traversing left s1 root and also abut the anterolateral aspect of the thecal sac on the left. Could be fibrosis or some extruded disc material....
This is your culprit! The extrusion is touching the transversing nerve root to the left you should be experiencing more left than right pain, but the transversing goes inbetween left and right hence the name transversing. could be bilateral.
Development of a schmorl's node involving the inferior end plate if l5 anteriorly

Thoughts new friends??
Nothing too serious seen, it depends on how much pain and discomfort you are in. I would try different alternative approaches to surgery. Read up on the condition and educate yourself about it
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Unread 11-15-2012, 12:41 AM   #4
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Nothing too serious seen, it depends on how much pain and discomfort you are in. I would try different alternative approaches to surgery. Read up on the condition and educate yourself about it
As you are post-surgical, was a contrast study not additionally considered?

Also, history, present complaints and clinical (exam) findings dictate what imaging studies need to be done (and for which findings correlated to said exam findings) so...the thought of diagnosing solely by fractional imaging findings that are retrospective to undetermined history, symptoms and clinical findings is more akin to witchcraft or channeling in it's preminitions and is tantamount to paddeling upstream in flood conditions without oars or floatation device (as a non-swimmer).
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Unread 11-15-2012, 09:11 AM   #5
gatorhead
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I read this and responded late into the night and looking back at it, the area you have trouble with, is the area you had the surgery on.....there should be no disc material there!

Again Dubious is correct that a contrast would have been much more beneficial in this case, and may have helped them to see what the extrusion really is.
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Unread 11-15-2012, 10:20 AM   #6
Nacho34
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Originally Posted by gatorhead View Post
I read this and responded late into the night and looking back at it, the area you have trouble with, is the area you had the surgery on.....there should be no disc material there!

Again Dubious is correct that a contrast would have been much more beneficial in this case, and may have helped them to see what the extrusion really is.

Agreed! That's what threw me off. I wasn't expecting to see disc material resting on that nerve root again.... Frustrating!!! I just don't really want to get sliced open again, that was no fun....
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Unread 11-15-2012, 01:09 PM   #7
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Agreed! That's what threw me off. I wasn't expecting to see disc material resting on that nerve root again.... Frustrating!!! I just don't really want to get sliced open again, that was no fun....
I looked it up, apparently it is common to only remove the part of the disc that is causing issue. There fore it is possible to have that issue at that site again.
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Unread 11-15-2012, 01:43 PM   #8
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I looked it up, apparently it is common to only remove the part of the disc that is causing issue. There fore it is possible to have that issue at that site again.
oh, i know that... it just pains me to see that apparently the surgery was all for naught... having the same exactly problem with bilateral leg pain/numbness when i only had it in one leg two years ago is frustrating! oh well.......
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Unread 11-15-2012, 02:56 PM   #9
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They never take ALL the disc material or else you'd have bone on bone. They'd otherwise have to put something in there to replace it.
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Unread 11-15-2012, 03:07 PM   #10
Nacho34
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Originally Posted by gatorhead View Post
I read this and responded late into the night and looking back at it, the area you have trouble with, is the area you had the surgery on.....there should be no disc material there!

Again Dubious is correct that a contrast would have been much more beneficial in this case, and may have helped them to see what the extrusion really is.
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They never take ALL the disc material or else you'd have bone on bone. They'd otherwise have to put something in there to replace it.

Correct. I understand that they don't and weren't going to remove the disc but I'm just thrown off by the issue popping back up worse than it was before after 2 years of being EXTREMELY cautious with my back... I'm a young person at 30 and am obvi not ready for non step bed rest or having to act like and 80 year old that can't pick up a grocery bag....

Do you guys think I should try to get this fixed considering the severe nerve pain and numbness/reflex issues in the opposite leg? Need advice bc I don't want to get pushed around by the doctors like last time.
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