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L4/5 Laminectomy- post dural tear

benjmn31bbenjmn31 Posts: 2
edited 01/12/2015 - 2:37 AM in Back Surgery and Neck Surgery
Symptoms pre-op
Numbness/tingling left foot
Chronic low back pain

Last Jan 2014 I had a Laminectomy of l4/5 the 2 weeks later had a post op Dura tear. So back to back procedures. I was doing fine for the first couple months then started to have pain come back. I had a fall back in Oct that caused a lot of new pain and spasms in my lumbar region. Below are comments from my 4 MRI's since Jan 2014. As of today I now have Rt and Lt side Sciatic pain, still have numbness/tingling in lt foot and leg, Rt foot feels tingly on occasion. Still having low back pain. It is becoming really difficult to sit, go from a sitting position, putting on shoes....etc. I just had an epidural injection Dec 4 2014 for this and I'm going to be receiving a caudal in ejection with ESI nerve block. The surgeon is telling me my options are to try and remove scar tissue and more disc material, possible fusion, or possibly do a disk replacement. I would like to hear if anyone has had to deal with any of these things and their outcomes. I appreciate all comments and advice.

Completed:8-Jan-2014 Comments: Rose Radiology - Films and report available for review - At L4-L5, there is annular disc bulge with superimposed left paracentral posterior disc protrusion with large downward extrusion on the left. There is complete obliteration of the left lateral recess with impingement of the left S1 nerve root and encroachment on the left side of the th4cal sac with impingement of the left S2 and S3 nerve roots within the thecal sac. There is mild impingement on the exiting right L5 nerve root from a small facet spur despite the mild degree of right foraminal stenosis. There is mild left foraminal stenosis without impingement. At L5-S1, there is mild annular bulge with su7perimposed broad mild central posterior disc protrusion with annular tear, causing mild central spinal stenosis without neural impingement. There is borderline impingement of the exiting right L5 nerve root in the right foramen from a small facet spur despite otherwise mild right foraminal stenosis

Completed:6-May-2014 Comments: Rose Radiology - Films and report available for review - Interval post-operative laminectomy change at L4-L5 with fluid collection at the laminectomy site. Differential considerations of fluid collections include seroma, liquefactive hematoma or infected fluid collection. Surrounding soft tissue enhancement is consistent with granulation tissue or inflammatory reaction. Clinical correlation is recommended. Ventral epidural scar extending tot he left at L4-L5 and centrally at L5-S1, consistent with post-operative change. Disc bulges with central annular tears at L4-L5 and L5-S1 noted. Stable minimal disc bugle at L3-L4. Minimal to mild lateral recess and foraminal encroachment at L4-L5 and L5-S1 appears stable by disc bugle and spondylosis. Straightening of the lumbar lordosis may indicate musculoligamentous spasm or sprain. No evidence of spinal stenosis or fracture identified.

Completed:30-July-2014 Comments: Rose Radiology - Previous laminectomy at L4-5 with diminishing size of laminectomy site fluid collection felt likely a resolving postoperative seroma or liquefactive hematoma. Scar tissue in the epidural space in the left lateral recess as well as ventrally at L4-5 is present. This scar tissue does appear modestly increased on the current study as compared tot he 5/2014 exam. There is also a small amount of ventral scar tissue at L5-S1. Interval development of a central disc protrusion and annular tear at L5-S1. Redemonstration of central/left paracentral disc protrusion and annular tear at L4-5. Redemonstration of minimal to mild bilateral L4-5 and minimal bilateral L5-S1 lateral recess and foraminal encroachment by disc osteophyte change and spondylosis. Minor disc bulge at L3-4 appears stable. Straightening of the lumbar lordosis re demonstrated which could indicate musculoligamentous spasm or sprain.

Completed:16-Oct-2014 Comments: Clearwater Imaging - Images and report available for review - Postsurgical changes are noted at the L4-L5 level with laminectomy defects. There is posterior, peridural enhancing fibrosis noted. Enhancement involving the posterior disc margin is also noted. There is moderate, circumferential, spondylotic bulge with grade I retrolisthesis. There is no prominent central canal stenosis. There is moderate, neural foraminal narrowing. At the L5-S1 level, mild grade I retrolisthesis and moderate, circumferential, spondylotic bulge is noted without disc protrusion or central canal stenosis.

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