Lipoma at Filum Terminale

[mc4580]

Hello,
Should I be concerned with the Lipoma? Previous studies indicate fatty tisue with no mention of lipoma. Have had several mri's in past 6 years this report seems to lack detail.

Jet Ski Accident 2006 followed by discketomy at l4 in 2008, posssible compression fracture form jet ski, Radioligist said Scholmers node L1-L2. Ortho said compression fracture, had mri done recently and now saying posssible lipoma.

Disc dessication can be seen throughout the lumbar spine with sparing of the L3-L4 disc level. The conus medullaris ends in normal position at L1-L2. As seen on the previous examination there is high signal intensity at the filum terminale suggesting lipoma.

L1-L2: There is mild disc bulging. No spinal stenosis or foraminal stenosis.
L2-L3: There is broad-based disc bulging. No spinal stenosis or foraminal stenosis.
L3-L4: Mild broad-based disc bulging and bilateral facet arthropathy. No spinal stenosis or foraminal stenosis.
L4-L5: There is mild central disc protrusion effacing the thecal sac. No spinal stenosis. Bilateral facet arthropathy is present. The exit foramina remain patent.
L5-S1: There is a central disc protrusion with disc material abutting both descending S1 nerves. This has progressed slightly since the previous examination. No spinal stenosis. The exit foramina remain patent.

Impression: Slight progression of the small central disc protrusion at L5-S1

Low back pain, pain and numness in right leg to foot. Numbness in left foot to middle of calf.

Trouble going to sleep at night due to pain in low back.

Tks

MC

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Lipomas are typically benign tumors, meaning they are usually asymptomatic. If they grow large enough, there could be compression of the surrounding tissue. I do not have the ability to view your images. Pain in the foot and leg is likely not from the L1/2 area. I would suggest that you follow up with your orthopedist to evaluate the lipoma and your symptoms. If you continue to have pain and numbness in the right leg/foot, you may need to be evaluated by a neurologist for an EMG/NCS to evaluate the location for your symptoms as well as possible etiologies.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[mc4580]

Thanks for your reply, I did visit the Doctor that sent me for the MRI today. He said same as you, unless I start having Symptoms with mid area numbness nothing to worry about will monitor it.


I have another question related to esi procedures previous PM&R performed several esi at L4 , L5, and SI of course it was one injection then follow up to review results and no more then 3 per year. These procedures were usually unpleasent. Dcotor said thats beacuse it was in the right place. Is it possible that the doctor (who was really trying to help seemed to be very caring) was trying to get to close to the nerve roots and irritated them. By unpleasent I mean I could feel a wave of pain felt like a mild charley horse from the injection site to my toes after thar I was numb for 20-30 miuntes. There was no long term pain directly related to the esi unfortunatey there was no long term relief either. Figured it was time to give someone else a crack at it. Present Doc said he will take that into account and will perform an esi at L5-SI in the next few weeks said for the first one he just wants to get the medicine in the general area  and go from there.

Thanks again

Happy Mardi Gras

MC