As some of you may know I have posted up on the boards a few times re L5-S1 disc herniation and groin/perineal numbness and down the left leg etc.
Im having a nightmare still, riddled with pain particulary in the lower back and legs. My so called spcialist has asked my employer to provide the intensive rehab that I require and state i had pre and post op Cauda Equina Symptoms.
I have stood my ground and have been referred to a leading UK Ortho hospital for a second opinion.
Could someone give kindly me some help on the interpretation MRI results i got today. There are 2 below.
FORMAT: examination performed as per standard protocol supplemented by post-contrast T1 sagittal and axial sequences.
Comparison is made with the pre-operative MRI study from 15/4/2009. A left L5 laminotomy is noted. The previously noted larged extruded L5/S1 disc fragment that was in the sacral canal is no longer present. There is, however, enhancing tissue surrounding the left L1 nerve root within its lateral recess, extending posteriorly to the anterior surface of the remaining cauda equina roots. The appearances are consistent with post-operative epidural fibrosis. Although there is a small residual central focal disc protrusion this does not appear to be compressing. No residual sequestered fragments are demonstrated elsewhere. A small collection measuring 19mm x 8mm axially by 4cm longitudinally is present within the base of the subcutaneous tissues overlying the surgical incision. No other significant interval changes are demonstrated.
Epidural fibrosis within the surgical bed, surrounding the left S1 nerve root and encroaching upon the anterior surface of the remaining cauda equina roots. No significant residual discal components are identified.
April 09 MRI
MRI SCANS OF THE SPINE
FORMAT: sagittal T1 and T2 weighted sequences obtained through the whole spine. Axial T2 weighted sequences obtained through the cervical spine and T1 and T2 weighted sequences obtained through the lower lumbar spine.
Note is made of marked loss of the normal cervical lordosis which may indicate muscle spasm. There is already spondylotic change noted but the canal is capacious and no evidence of any cord or thecal sac compression and no obvious nerve root compression. The cord is entirely normal in its appearance.
At the L5/S1 level note is made of an extruded disc fragment which fills the canal compressing the left S2 nerve root prior to its entering into its lateral recess (image 16 of 19). The right S2 nerve root is uninvolved. There is also some thecal sac compression at this level. The S1 nerve roots are normally positioned within their lateral recesses. No other thecal sac or nerve root compression present. There is mild L3/4 and 4/5 disc dehydration noted with high signal present posteriorly within the L3/4 disc. No other abnormalities of note. No para-vertebral abnormalities present.
1. Large extruded disc fragment compressing the left S2 nerve root and the thecal sac at this level.
2. There is evidence of an L3/4 annular tear.
*** Final Report ***
Any advice and help would be great.