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Focal Fluid collection (seen on mri)

sujowerssujower Posts: 4
edited 06/11/2012 - 8:45 AM in Lower Back Pain
I know you all are not drs. - but has anybody heard of this?

I had a 2 level fusion last year - (L4-S1). It was successful (I was able to function again!) My pain has been steadily increasing over the past 3 months - had an mri ordered by my pain guy and the mri reported a focal fluid collection present posterior to the thecal sac. My pain dr. had no idea what the heck this is and referred me back to my surgeon (who is on vacation for 3 weeks).

I appreciate any input at all - I hate waiting!

Thanks so much!!!


  • Sujower, Welcome to Spine Health!! Sorry to hear your pain has come back. A few years ago I creamed my knee in a fall (I hit so hard I thought I broke my Patella!). I wasn't in the country (US), so I waited until the next morning to seek medical attention over at the local Coast Guard medical facility. They did an exam, MRI and Ultrasound. I had major swelling (focal fluid build up)in my knee, and water on the knee as well.

    I am not medically trained at all, what I am stating now is based on my own experience - though mine was not in the spine. Okay? That stated, "Focal Fluid" is when you either have swelling of soft tissues, or fluid build up or both. I looked like I had 'two knees' but the Ortho doctor elected not to drain it, but put me on anti-inflammatory medication, told me to ice/heat it and rest. Spine wise, they might have you get an Ultrasound so they can see how much fluid is in there, and then examine you again I would figure, and make a plan.

    You might find like my knee, treatment is rest, meds, maybe PT - they have to figure out first what is causing it before they decide what to do. It could be as simple as modifying your activities to change how you load your back. You didn't say if it was in the fusion level or another level? If you are getting really concerned, I am guessing here, even though your Doctor is on vacation, do they have emergency contact, or another doctor in his office to answer your questions?

    I am a little surprised that your PM Doctor didn't know what focal fluid is...hummm...odd... I am with BlueCross BlueShield and they give us a card that we can call (free) and talk with a nurse, who will find answers if she/he doesn't know. Does your insurance offer such a service? Just tossing a few thoughts out.

    Please keep us posted, and again Welcome!!! :) HUG

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Ohhhh - never thought of the blue shield contact - I'm with them too - I will call them - I was able to get an appt with my dr that i had before my surgeon (a physiatrist) I will see him Monday

    - I too am puzzled by the pain dr's lack of knowledge on the scan - hmmmmmm. Anyway - thanks for the response - Lets pray for crazy inflammation!

    Thanks and have a great weekend.
  • Fingers crossed that it turns out to be a quick fix and nothing more serious. Yeah...BCBS has had the 24/7 nurse thing for like the last 10 years. I've only called twice, and they were always helpful and nice.

    Glad to see you have an appointment soon. Please let us know how it goes. Have a great weekend!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • :D

    Okay, here's a crazy theory. Maybe it's a seroma, which is a fluid filled sac. I developed one in my foot In June of 09 after a surgery I had in Oct of 08. The swelling developed at the incision site.

    My podiatrist was baffled and said in his 30 plus years of practice, he had never seen this happen. He tried expressing it a couple of times and then I developed blood poisoning from that procedure.

    I was seen by a dermatologist, my primary care doctor and finally an infectious disease doctor -- still all shaking their heads. I was on antibiotics for six or seven months and my foot finally healed up almost a year to the date that the swelling started.

    By the way, my foot starting expressing the fluid on its own from a hole in the top of my foot. I should have bought stock in band aids (LOL!).

    The theory behind seromas is that when you have surgery sometimes the body tries to fill the area where something was removed (my take on what I've read online about seromas).

    I think I'm safe in telling you it's nothing to worry about but it could just be a pain in your backside for a while. And yes, the swelling and fluid buildup was uncomfortable and caused me to limp around, especially in the mornings.

    Good luck and I'll be interested to hear how you make out.


  • Well Judy - lets just hope that my lower back doesn't start leaking fluid like your foot did - could end up being pretty embarrassing!!!!

    Thanks for the theory - I am really praying for the easy answer - somehow with me it doesn't usually end up being that way - but there is a first for everything!

    Enjoy the sunshiney weekend!
  • I had a fluid buildup (no fancy name) around the vertebra that was fractured and the one that was bruised. I also had alot of fluid buildup around my incision which the PT massaged away.

    I was told that the fluid is just like the fluid you get around a bug bite or even a pimple or a blister. It's the bodys way of protecting an injury or a foreign object inside the body. And just like your momma told you it's better not to pop it. They should look carefully to see what is going on. An MRI and a CT should be done. And then maybe a sonogram but I think the MRI is probably better.

    Can't wait to hear what they say.
  • Su,

    I gotta tell you, I'm looking forward to hearing what they have to say too.

    My fusion was 21/2 years ago. About 8-9 months in I was experiencing increased pain. We did an MRI. I really don't recall what the technical name they called it but there was some kind of fluid build up in there.

    Anti-inflammatories, antibiotics, and steroids were prescribed.

    Keep us posted. The nerve of your surgeon to go on vacation at a time like this. (You'd think he had a stressful job or something.)

  • Well - saw my dr. today - I am so blessed to have found this guy - he always puts me at ease (not too mention he is a fabulous dr). The fluid collections are from the surgeries. Its basically a collection of left over blood and fluid - bodies way of handling it. It is causing no harm and should hopefully over time be absorbed into my body.

    The increased pain is partly due to arthritis in my facet joints - I got 8 facet injections that should help relieve the pain for now. In addition - my back is so thin (god I never thought anyone would say that to me) that the hardware - mostly the screws are being rubbed. That they cannot do anything about - I am going to have to build up the muscle in my back (roids anyone?)

    All in all I am pleased with my results - I am extremely sore and sooo thankful for drugs

    Thanks to everyone here for their support and love - there is no place like this!!

    love and light

  • So glad to hear it indeed turned out to be okay. I can 'feel' your stress reduced in your post! You have fellow spineys here to lean on whenever you need or want us! So glad to hear the news was GOOD!!! *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • So glad to hear its nothing serious. Hope the injections help once they stop hurting - lol.
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