HealingWell
Search Close Search
☰

lumbar and cervical fusions

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 11/11/2008 9:18 PM (GMT 0)

Hello,

   I was wondering if someone could explain to me some findings on my latest MRI report 10/05/08.

I had an anterior interbody fusion at  L-4-L5 with the double barrel cages and plate with pedicle screws 02/25/08.

   Findings: Sequelea of L4-L5 anterior interbody fusion are noted. There is mild body marrow edema involving the posterior halves of the L4 and L5, likely postoperative all other levels are within normal levels.

   However; An MRI report 01/09/08 showed mild diffuse anular disc bulge L3-L4,and of coarse significant findings at L4-L5, mild diffuse anular disc bulge at L5-S1.

   There is mild decreased T2 signal in the intervertebral discs at L3-4 and L4-5 secondary to degenerative desiccation there is mild narrowing at these levels

   Impression; there are diffuse anular disc bulges at L3-4,L4-5,and L5-S1, worst at L4-5 with moderate left sided neural foraminal stenosis and mild right sided neural foraminal stenosis.

   Why would the 10/05/08 MRI not show disc bulges? What is Sequelea of L4-L5 anterior interbody fusion? What is mild body marrow edema involving the posterior halves of the L4 and L5, likely postoperative. Would the degenerative desiccation at L3-4 go away? Finally why would that be post operative almost 8 months later?

   I have tried to use the Internet and research this on my own and became confused and frustrated. Is this a disc disease? Do disc bulges disappear?

   I've also had an anterior fusion at C5-6,C6-7. The 01/09/08 MRI showed encroachment upon the anterior left side of the thecal sac. What does that mean and can that get worse, because my neck is in almost constant pain? The pain radiates from the neck Through mid back and down through my shoulders "Kinda like the shape of a bird in flight.The head of the bird feeling like a knot".

   My doctor called me after the last MRI and told me there was nothing more surgically he could do for me. That I would have to continue taking my pain medication and live with the pain "Which is quite excruciating at times" and that I may want to see a neurologist.

   Would some one please help me cypher this?

 

Posted 11/11/2008 10:53 PM (GMT 0)
Dear Number9.
Welcome to the HW Chronic Pain forum. First, you need to know we're not doctors here. We can provide support, and share our experiences, but a lot of the details you're asking for need to come from either your neurosurgeon or perhaps a neurologist.

Since I've had a double fusion (L4-S1) I can share some opinions of what I think, but they're just opnions. When you have a fusion I believe all the disk material is removed, so you'd no longer have the bulges, etc. For me, the doctor did a diskectomy and a fusion; I think that's always the case but I don't know. Then the disk is replaced with either bone graft or some other material (depends on what your surgeon uses-mine used a protein substance) and the screws, etc. support the spine until the material fuses on its own. You really can't compare the MRI from before the fusion with the post-fusion MRI - at least not at the site where the fusion was done. It'd be like having a knee replacement and then trying to compare a knee MRI from before the replacement with an MRI of the artificial knee.

Degenerative disk disease in the rest of your spine likely will continue. That's a normal part of aging, but for some of us may occur at a faster rate, probably due to any number of factors. It's not uncommon to have problems at other levels of the spin, and since you've also had cervical fusions, it may further destabilize the remaining segments of your spine to fuse any more. Plus, you're still likely to have pain. That's the sad thing many of us have to accept. While my surgical fusion was technically "successful" it did not succeed in relieving my leg and foot pain. I'm left to manage it with medications. That's likely what your doctor is saying. There's only so much surgery can do, sadly. But a neurologist or pain management specialist can probably help assess what other possible treatment approaches may help manage your pain. For many of us, the pain never goes away; we just try to get it low enough to function. Read a lot of the posts on this site and you'll get the idea. I wish I had better news.

Edema, by the way, is swelling. Postoperative means it likely occurred after the surgery. Swelling of course can place pressure on nerves, and continue pain. Whether anything can reduce that edema, where it's located, etc., is a matter for your doctors.

Hope this helps some.

PaLady
Posted 11/12/2008 12:19 AM (GMT 0)

Hi

I cannot help with the mri report, however I do know what the neck pain is all about.

I have had a fusion C5 C6 and Laminectomy at C6 C7 T1.

I also continued with pain and neuropathy in my arms and hands. I could not be upright for

more than 20 min at a time without a 7-8 pain level.

My surgeon also said he could do nothing more at the time until I got worse (meaning the discs total degenerated)

Then diagnosed Myofascial Pain Syndrome.

Worth your looking into.

With the stretches to release the MP in my lat muscles and my pelvis, also lots of Neurontin.

I am actually able to work again.

Sounds like the same muscle you are having a problem with. From neck down at an angle and a knot at the muscle just above

the shoulder blade.

I hope you research this and then try to find a MFP therapist, a Dr of Osteopathy is the best, however some massage therapists are

trained in myofascial release.

It may help you.

I know those of you who have read my MFP stuff before are probably getting tired of it.

It was however a "miracle" for me. To go from disabled to working in a few months.

I still have 5-6 level pain all day at work but I am still doing it! ! !

Bonnie

Posted 11/12/2008 1:33 AM (GMT 0)
N,

PALady gave you a pretty decent explanation. I would only add to that that I'm not sure having someone explain what all that means will actually help anything. Unless you're quite young (25 or younger), disk bulges & their precursors, dessication (referring to the drying out of the center cushion of the disc) are quite common and don't necessarily mean anything. If it were me, I would seek out the help of a good Pain Management Specialist. It really sounds like all the surgical options have been done & what is left is physical therapy & pain control.

Pain Management doctors can be anesthesiologists or neurologists. I haven't found any benefit of one or other. There are a lot of non-surgical options to treat your pain and it may be worth it to explore them. That said, some people just take longer to recover from surgery than others. Fusion surgeries are fairly major procedures. If you haven't had any blood work run since the operation, it might be worth it to get your Blood Sedimentation Rate (or "sed rate") checked by your PCP. This test measures inflammation. If the number is still elevated, chances are you body just needs a little longer to heal. Sometimes it can take 12-18 months for slower healers to recover (in spite of the aggressive 2 week recovery time lines the surgeons regularly promise). I know that has been my case a few times & all I had to do was give it more time & the pain substantially subsided.

take care & good luck with finding a specialist.
frances
Posted 11/12/2008 12:38 PM (GMT 0)
Thanks all,

There's one more thing maybe some one has had experience with. I've had 9 surgeries. 7 of them have been in the last 4 years. They've all been joint and ligiment related. Acl reconstruction miniscus tears bone spurs large and small everywhere, ect. Has anyone had this type of thing happen? I'm only 40. Is there a desease that would cause my cartiledge to deteriorate? Maybe fibramialga?
Posted 11/12/2008 1:43 PM (GMT 0)

hi number9, well I can say I know how you feel with all the surgeries. I have pretty severe degenerative joint disease, and I have had 9 surgeries also, tomarrow I will have the 10th one. I have had both knees replaced, both hips replaced, 4 spine surgeries at L4-5, one hip came loose and was infected for 2 years before I found a Dr. to diagnose the intense pain, so I had a revision of that hip (2 more surgeries involved, and 4 months in the hospital on antibiotic IV's) tommarow I will have spurs taken off the left shoulder, then wait to heal to have the right shoulder done as well. My right jaw is popping and cracking, and they want to fix that degenerated joint as well shakehead Mine started at the age of 27 or 28 (57 now) I do know that I could not drink milk as a baby and they gave me injections of calcium and my body did not utilize the calcium. and I attribute that to my degenerative disease and arthritis.

I don't know if this is your problem or not, could go alog with fibromyalgia as well as DJD I hope everyone has a pain free day

Hugs, Patty

Posted 11/12/2008 6:42 PM (GMT 0)
Numbers and Moondancer,
Wow - all those surgeries! I so feel for both of you! But you raise a good point, moondancer. Everything I've read tells me that calcium absorption when we're younger (I'm 58) is important for bone health; it's not all about us taking supplements as we're older (esp. women) although that's needed, too. I wonder how much this might relate to many people's problems.

PaLady
✚ New Topic ✚ Reply