Do I need surgery? If not, what else can I do?

[reginamarie10271]

I am 39 years old and in August 2010 had a synovial cyst removed L5/S1, laminectomy. I was pain free for only one month. Since Oct. I have had pain in my left thigh but recently it has gone into my left hip and groin as well. The pain is unbearable. MRI on 12/24 shows... moderate to marked left sided recess stenosis L5-S1, left sided facet arthritis causing mild sac compression,left sided facet joint effusion, contiguous10 x 8mm synovial cyst(Yes, it grew back!!),moderate to severe left S1 root compression. I contacted my surgeon. He can't believe the cyst grew back. I am seeing 2 different surgeons for opinions next week. I have tried massage, PT, epidurals, lots of Neurontin and heavy duty narcotics, TEMS unit, heat, ice..The only time I am not in pain is when I am lying down on my right side, that's it. Sitiing, standing, walking are unbearable. I get these strong stabbing pains in my thigh and groin that bring me to my knees.I am a teacher and have to stand all day. Do I need another surgery? What can I do?

[Abhijeet Ghosh]

Dear Friend,
The cyst has regrown. Hence need for biopsy becomes high. It helps us to know the nature of the cells, inside the tissue.
Surgery would be Excision biopsy of the cyst as well as recess stenosis excavation.
Since there is a stenosis in the lateral recess, the space needs to be increased in the lateral recess, so as to get more space

Regards

[reginamarie10271]

I posted the question to three different forums, neurology, back and neck surgery, and back and spine surgery. I paid $15. They don't tell you what doctor you will be writing to.I didn't know that you were the expert for 2 of them. Are you the expert for neurology too?
I did get this post. Thank you. I did respond to this post in the other forum and asked you "what kind of surgery would I need and what would it entail?"
You mention biopsy. The cyst can be cancerous?
Thanks again.

[Abhijeet Ghosh]

Dear Friend,
I have already answered you about this problem in my previous post with you.

The answer is as follows -

It's really unbelievable to see the cyst re-grown as well as seeing the left side recess stenosis, though laminectomy was done previously.
Yes, you would require a surgery as the present condition is too painful and surgery is the only way of relief.
Beside surgery presently i can't think of any other option as all those, if done, will only be for pain control and would soon exhaust out.
Hence please do consult a good orthopaedician who specializes in spine for a final verdict and planing for surgery.


Would like to add on it. Do discuss about sending the reports for biopsy also.
Please feel free to discuss further.
Regards.