Did not understand how my doctor explained my mri

[RickK41]

If anyone could explain my MRI report to me in a more simple way than what my doctor did I would really appreciate it because I had a Decompressive Lumbar Laminectomy done at L5-S1 11 months ago and now I am in just as much pain as i was before the surgery.  The bad part about it is that my surgeon told me he did not have to see me anymore and for me to go see my family doctor if I had any problems.  That was 6 months after the surgery when I went to him still in pain.

Comment: The conus medullaris ends at the level of T12 vertebral body. The visualized portion of the spinal cord and the nerve roots are without mass or signal abnormality. The patient is status post bilateral laminectomy efects from L3-L4 level down to L4-L5 levels. There is mild congenital spinal stenosis in the mid lumbar spine. Bertebral bodis are normal in stature and in alignment. Mild disc desiccation is seen at L4-L5 level.

At L1-L2 level, minimal broad based posterior disc bulge is seen causing minimal compression of the thecal sac and mild bilateral neural foramina stenosis.

AtL2-L3 level, minimal broad-based posterior and lateral disc bulge is seen with bilteral facet joint hyperrtrophy. This is causing no compression of the thecal sac and mild to moderate bilateral neural foramina stenosis.

At L4-L5 level, mild broad-based posterior disc bulge is seen with focal central disc protrusion. Bilateral facet joint hypertrophy is seen. Combination of this finding is causing mild mass effect on the anterior portion of the thecal sac and severe bilateral foramina stenosis.

AtL5-S1- level, minimal broad-based posterior and lateral disc bulge is seen with mild bilateral facet joint hypertrophy. This is causing no compression of the thecal sac and moderate to severe bilateral neural foramina stenosis. Post contrast-enhanced images demonstrate mild enhancement of the posterior epidural space at the surgical site and around the bilateral L5 nerveroot within the spinal canal at L4-L5 level likely representing scar tissue.

Impression: Postsurgical changes with degenerative disc disease as described.

[zoey123]

You say you had a laminectomy at the L5-S1 level, but your MRI mentions the surgery affected the L3-L4-L5 levels.  Where the MRI says "mild" there is usually no problem, other than normal "wear" on the spine, and doesn't equate with pain.  Your pain is no doubt coming from the L4-L5 level, which shows severe foramina stenosis.  This will cause nerve impingement.  Only your surgeon can tell you if this is a result of more degeneration, failed surgery, or if the laminectomy was done on the L5-S1 level, due to the extra stress taken on by the next level.  Either way, your surgeon is probably trying to avoid further surgery so as not to complicate the matter (multiple laminectomy/fusions are less successful than those only done on one level).  You must talk to your g.p. about this to see if he has any alternate treatment he can recommend.  If not, he can refer you back to the surgeon where he can be more clear to you on why he doesn't want to tackle it again.  I am taking my time trying to decide whether or not to have surgery as this is exactly the problem I want to avoid.  Unfortunately, not all surgeries are successful, even if repeated.  But you have to hear what your options are from a specialist.  Good luck to you ...

[selmaS]

I agree with whipper...u had DDD as noted in the impression...this is something we all get with age....however, above that it mentions stinosis....which is a narrowing of the area in question.( spinal canal)....u also have several areas where ur disks r bulging....it does not mention ne inpingment so not pinched nerves from what I can tell, but I would go to a spine specialist and get a 2nd opinion. Ur dr apparently is lost....and it is easier to let u go then do a follow up.

I have not had this surgery, so I do not know how long it takes to recover....keep in mind everyone is different....I know I heal at a slower rate than most....so I expect things to take longer.Have u had PT?...if so what did the PT say?


"selma"

[whipper]

I am concerned why your surgeon told you not to come back to see him.  You need some professional advice.