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Neurology (Expert Forum)
perineural fibrosis
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perineural fibrosis
by tracynthurman, May 20, 2002 12:00AM
In Sept. of this year I had a lumbar laminectomy& discectomy at L4-5 & L5-S1 for ruptured discs and spinal stenosis, a full year and a half after the injury.I am now in more pain than before,and have more leg pain.I have also experienced fasciluations in both legs after surgery. I recently had a post-surgical MRI with and without contrast showing: " at L5-S1 there is blurring of the epidural space to the left. After Gd injection, there is fairly intense and uniform enhancement in this area. At L4-5, ther is evidence of laminectomy on the left with postsurgical changes noted. Also, peri-neural fibrosis around the S1
nerve root on the left."
Do these results give any explanation for my continued and worsening pain?
What is the "blurring of the epidural space" caused from?
What caused the intence enhancement?
Is this indicative of arachnoiditis?
Thankyou for your time.
nerve root on the left."
Do these results give any explanation for my continued and worsening pain?
What is the "blurring of the epidural space" caused from?
What caused the intence enhancement?
Is this indicative of arachnoiditis?
Thankyou for your time.
Doctor's Answer
by CCF-Neuro-M.D.-JT, May 24, 2002 12:00AM
Unfortunately, it is impossible to accurately comment on an MRI I have not personally reviewed. However, there are a few things I can comment on. WIth arachnoiditis, there is typically an appearance of clumping of the nerves, or adhesion on imaging studies which you don'[t report here. Have no idea what "blurring" means - would have to see it myself, but most likely it has tsomething to do with post-surgical changes. Enhancement means that the area "lights up" on the MRI due to uptake of the dye in this area. This can mean a number of things including post-surgery changes (usually recent), infection, active disc disease as well as other things that may not pertain to you like cancer. The report is limited and does not explain your symptoms itself. This does NOT mean that the answer is not in the MRI, just that the report is so brief. What would be helpful to you is to bring the MRI to the neurosurgeon or get a second opinion. Have them examine you and look at the films themselves to figure out what's going on. The fasciculations represent nerve damage to the muscles in your legs. As the pain is worse, at the very least you should talk to your primary care doc to get symptomatic pain relief. Good luck.
Member Comments (1)
by Snoopy331, Oct 26, 2008 08:08PM
A related discussion, Is there treatment for Perineural Fibrosis of the S1 nerve root on? was started.
