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Husband is having his 3rd lumbar surgery

rdavis46rrdavis46 Posts: 33
edited 06/11/2012 - 8:56 AM in Back Surgery and Neck Surgery


TECHNIQUE: Contiguous axial images of the lumbar spine were acquired using 1.25
mm collimation. Reformatted images in sagittal and coronal planes were created
by the technologist per physician protocol. The current examination was
performed post discography. Discography was performed at the L1-L2, L2-L3, L3-L4
and L4-L5 disc space levels.

COMPARISON: July 1, 2011.

FINDINGS: Postsurgical changes involving the lower lumbar spine are identified.
There are interpedicular screws at the L5 and S1 levels with posterior fusion
bars. Cage device is seen at the L5-S1 level. There appears to be sclerosis and
calcification within the L5-S1 disc space. Postoperative laminectomy defect is
seen at the L5-S1 level.

The lumbar spinal alignment appears normal. The vertebral body heights appear

T12-L1: No focal disc herniation is seen. No central spinal stenosis is

L1-L2: Contrast is distributed within the central aspect of the disc space. No
definite annular tear is seen. No focal disc abnormality is seen. No central
spinal stenosis is dentified.

L2-L3: Contrast is distributed within the central aspect of the disc space. No
definite annular tear is seen. There appears to be a small Schmorl's node
involving the superior endplate of L3. Subtle diffuse disc bulge is seen causing
slight flattening of the anterior aspect of the dural sac. AP diameter of the
central spinal canal remains over 10 mm.

L3-L4: Contrast is in the central aspect of the disc space. No definite annular
tear is identified. Subtle diffuse disc bulging is seen causing slight
flattening of the anterior aspect of the dural sac. AP diameter of the central
spinal canal remains over 10 mm.

L4-L5: Disc space narrowing is seen at the L4-L5 level. Extensive tear of the
annulus is identified. There appears to be a component of free extravasation of
contrast consistent with a Dallas IV classification. Compression of the anterior
aspect of the dural sac is seen. There is loss of the epidural fat planes. The
central canal appears to be greater than 10 mm. Mild bilateral neural foraminal
narrowing is seen. Mild bilateral facet joint prominence is identified. There
appears to be mild diastases of the right and left L4-L5 facet joint.

L5-S1: Narrowing the disc space is identified. No central spinal stenosis is
identified. No focal disc abnormality is seen. The neural foramen appear patent.
Postoperative laminectomy changes are identified. There is bilateral facet
joint fusion.

1. Degenerative disc disease at the L4-L5 level with what appears to be
extensive annular tear with free extension of the contrast into the central
spinal canal. There is loss of the epidural fat planes at the L4-L5 level and a
mild degree of central spinal stenosis.
2. At the L4-L5 level, there appears to be facet joint widening with air in the
right L4-L5 facet joint


  • can anyone explain to me what this all means. I know he needs a fushion for the L4-L5 he said he wasn't taking out the disc so just dont' understand why they wouldn't or how will this relieve the severe stingy pain he gets in his back travels down his hip and legs. Especially on the right side but now it is down both at times. Worst on the right. Waiting for the surgeon office to call back to set up his surgery. He is 49 yrs old and had the L5-s1 done twice one from the back and the other thru his stomach we almost lost him then that surgeon had a general surgeon open him and move his organs out of the way but he nick his main artery to his heart and had to mend it back together so instead of a 2 hour surgery it was a 7 hour and nobody told me until they were finish. So he is afraid to have surgery again especially thru the stomach. His new surgeron said he will not go thru the front because of the risk and alot of scar tissue will be there as well. He says he alot of scar tissue around his last 2 surgerie so maybe that is why they take out the disc. So what do they do for anual tear?
    We spent the whole summer going for injections even injection in his hardware. And all summer nothing but test and then in August they told us nothing they can do for him but take out the screws or put in electric stim. Then he sent a request to his pain management dr to see what he want to do so wrote on the paper work disogram vs electric stim or hardware removal. A week later get a call to set up his discogram and so darn happy that we had it now we have answers of where his pain coming from. They had to stop the test in the L4-L5 it was to painful for him and guess he had leaks out of that one. They barely got up to 40 percent of pressure. The others had no problem with some bulging but the L1-2 was the normal disc so they use as there tester. He said it felt like he went thru surgery after this procedure and still in so much pain.He falls alot and has a walker with seat. but doesn't use it all the time when he should yesterday he had to hold onto the counter said hurry get my walker. I hate seeing him in so much pain. He been disabled for years and it bothers him that he can't work he hasnt' work in years. I know he won't be cured from this surgery that he will have some relief. The neurosurgeon said he will have a 50/50 percent chance that it will work or get better. That is better than where is now hard to function anymore. He is having trouble getting up to walk first thing in the morning. Even sitting to long makes it hurt more as well. If it take his pain away down his hip and legs I think he would be happy with that. And the stingy type pain. This is first time having a neurosurgeon do it. He always had a orthopedic surgeon do it. So we went to see this doctor he was very through his old one sent us to a pain management dr for injections and gave him neurontin which neither help him. He didn't order any test we had the mri done by his family dr but he wouldnt' do further testing. So glad we got our family dr to refer us to the neurosurgeon. But seem to take a long time to get to this point. he even did 3 months of phsyical therapy which she call his family dr and told him she is hurting him more than helping him and she suggest an mri and after that was told it was the L4-L5 but no surgeon thought it was bad enough to warrant surgery. But after the discogram boom its surgery time. I know the surgeon didnt' want to put him thru any more surgeries he said he was to young and he rather not do surgery because he has had several and the more you have surgery the risk of other disc going to bad over years. Which is true as he had them in 2001 and 2005 so it is like a few years boom another disc goes. He has the degentative disc disease. and he is prone to these problems. I am glad I push to find out answers I kept telling him that I can't sit here and watch my husband be in so much pain and just miserable. We need answers not to put a bandaid on the problem. Maybe in the future he may need this elect stim but glad he isn't because of the bad disc it needs to be fix first. Well sorry for such the long post got alot of my mind. His anxiety is high he has bipolar, diabetes, high blood pressure and high cholestrol and asthma so got alot on his plate.
  • Welcome to spine health. So nice to see loving, caring family members on here. Sorry that your husband is having so much pain, and I am sure it is hard on you as well. My husband, and I both have spinal problems, so know the feeling on both sides.

    We are unable to interpret MRI findings. It is best left up to the doctor. Glad that your husband was refered to a neurosurgeon. Does he specialize in the spine? Before surgery it is always good to have more than one opinion.Is your husband on any nerve medication (stingy pain, you mentioned)?

    Wishing you both all the best. Hope that your husband soon gets some much needed relief.

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • Yes he was on neurotin and with him being bipolar I didn't even want to be home with him. It change his moods but the doctor kept insisting that it would get better so went thru that from June to end of august now on lyrica 50 mg 3 times a day start him on low dose to see how he does.

    We did go back to his orthopedic surgeron and he just sent him back to the pain management doctor for injections. And after him and hubby got into it because we wait over 2 hours to see him and his assistant came first and he went off on her as we were already waiting to see the surgeon for a very long time. He said I didn't come to see you I want my surgeon. Well she went to talk to the surgeon and he told he won't see him until she sees her and exams him. He wouldn't cooperate well he is in so much pain and waiting that long is crazy. I finally got him to agree to do it. As they were about not going to see him. The dr came in for a few minutes only said go do the injections and come back. But then he went off on hubby and yell at him if you ever treat my assistant who is my right hand man (lady) that he would throw his a** right out of there. That is when we went back to his family dr and request to see a neurosurgeon. All they did for him was put him on that horrible neurontin the generic form 150 am and 300 pm. didn't even help with his stingy pain either.

    He had mri, ct scans, xrays both cervical and lumbar. He also had eeg, sseep think that is what is has to do with the nerve to the brain very long test. Also did hardware test where they injected into his screws.They try to say it was that or to have stimulator in. We want answers of what is causing his pain. Not to continue to put bandaids on the problem. Even his family dr said the same thing. My hubby didn't want to go thru the discogram but his family dr explain it to him that will help them more and end this constant bandaid treatments.

    His last surgery too he had to have a discogram as well which was the L5-S1 which he had done back in 2001 but they had to go thru the stomach that time around. So glad he doesn't this time. He said he would refuse to do it from the front. And his neurosurgeon he would not do it either.He will not take any unnecessary risk!

  • sorry some how it double posted on me
  • It was excruciatingly painful. 4/5 lumber levels were 9/10+ and the L3/4 was pressure only even though it was just as torn as the others as shown on the cat scan afterward.
    The L5/S1 almost made me pass out it was so bad.
    I shudder when I see his experience because even though my ACDF C456 went verywell 7yrs ago, I have an L5/S1 ALIF tomorrow.
    Dr says 2-3 days in the hospital 2-3 weeks no driving 6 weeks no lifting and 6 months to "normal".
    I hope for your husband to find the magic bullet of recovery somewhere in this path and I hope my path is not as grim. My wife is very supportive and starting to get anxious and fearing all the negative possibilities. I don't have a choice in the surgery as I know I cannot continue to live without something changing. And, I am a spiritual person and do not believe it's in human hands either. It will be the way it's supposed to be and I trust in a higher power to decide. He gave ms a surgeon who fixed me once and hopefully can do it again.

    Good luck in your path. Recovery is not a destination but a path.
  • Hi there,

    Your husband is very lucky to have you. I know how much I appreciate the support, questions, concern that my husband has shared for me.

    That being said, can you get a 2nd opinion before proceeding with the surgery? Even if you are comfortable with your current surgeon, a 2nd opinion sometimes gives you the peace of mind you need or at least the questions to ask of the original surgeon.

    I always get at least a 2nd opinion...worth the time and money.

    If you already did this and still have concerns/questions, schedule more time with the surgeon. Ask him everything you are listing here.

  • He is the doctor with the 2nd opinion and we switch to him (neurosurgeon) after the fall out at his orthopedic surgeon. And he wouldnt' even discuss surgery at all.Just sent him to get injections which never work in the past. It took them the whole summer to figure out what is wrong with him. We have the answers and now we have to get ready for another surgery. We never went to a neurosurgeon before always gone thru a orthopedic surgeon.
  • So you are having thru the front so going in thru the stomach right? Be careful with that one I almost lost my husband when they did that last surgery. because they already went thru the back for L5-S1 they had to go thru his front because already had a previous on those disc. But they nick his main artery to his heart and had to mend it back before even starting the surgery. They said it was rough going it took 7 hours instead of the 2 hours and they came out and told me there was a problem. They call me on the waiting room phone after 7 hours to let me know what happen and they are closing him back up now. Talk about a nightmare. So hubby is so scared about having another surgery. the neurosurgen said he will not go thru his stomach to risky and there is scar tissue there and after this problem last time to darn risky. He is anxious about it and last night says I am going to die if I have this surgery not going to make it thru it. I told him you did fine before sure there was a problem but they are not going thru the back and you are much healthier now and we need to stay positive and pray that things will get better.He can't stay the way he is now he suffers so much in pain. walking with a walker with seat due to he falls alot. He wants to get a electric wheelchair or scooter but the scooter is to big to get around our house since it is small.But his family dr said he is afraid that he will lose any strength left in his legs to walk so he said lets try the walker. He was using a cane before that but the walker is more supportive for hi. Also if he feels like falling or legs ready to give out he can have a seat right away. The other day he was holding on the counter and said get my walker fast. He don't use it all the time which I think he should use it more to get around better. but he is stubborn he can't walk far. and mornings are so bad when he trys to get up. There are mornings he think he won't be able to walk. The pain and feeling like his legs won't work. I told him the only way to get relief is to have the surgery
  • I did ask about taking out the bad disc and he said that it does not need to come out that stablizing it by a fushion with screws will help
  • My aunt just had that. I think she had/has stenosis. So they put in rods/screws/a cage to stabilize the spine but they did not remove the disc.

    Not sure if it's the same but I have heard where they leave the disc in tact.

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