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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is persistent pain after a laminectomy indicative of a spine fracture?

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Dr. Muhammad Ali Rauf

General & Family Physician

Practicing since :2013

Answered : 1306 Questions

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Posted on Wed, 23 May 2018 in Back Pain
Question: I had a discectomy and I woke up in excruciating pain. A week later a laminectomy to stop the pain. Epidural injection,Morhine,Dilaudid, nothing helps. Something does not seem right. My Dr. has released me and says it will take a year to get over this. Is it possible that my vertebrae was fractured? My Dr. said the disc had hardened and had to be broke away.
doctor
Answered by Dr. Muhammad Ali Rauf 1 hour later
Brief Answer:
Images are limited for assessing fracture; pain occurs after surgery

Detailed Answer:
Hello

Thank You for contacting HCM. My name is Dr Muhammad Ali Rauf & i will look into your problem.

I have gone through your query and would try to help you in the best possible way. Image you provided is single and its difficult to assess complete vertebra status. If i consider only this image then chances of fracture is unlikely. However, for proper assessment i need all the images. Post surgical pain occurs in such cases and it usually takes some time to show improvement. You need to continue taking analgesic medicines along with physiotherapy.

Hope I have answered your query. If you have any further questions I will be happy to help.
Wishing you good health !!
Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Muhammad Ali Rauf 33 minutes later
Am I allowed to upload a mri disc?
doctor
Answered by Dr. Muhammad Ali Rauf 1 hour later
Brief Answer:
Yes you can share complete data

Detailed Answer:
Hello

Yes you can share complete data by emailing it at YYYY@YYYY with Sub: ATTN 'Dr Muhammad Ali Rauf'.

I'll get back to you as soon as i receive the images.
Thank you
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Muhammad Ali Rauf 2 days later
Uploaded report
doctor
Answered by Dr. Muhammad Ali Rauf 11 hours later
Brief Answer:
Fracture noted at L4 & L5 vertebra level; please see details

Detailed Answer:
Hello

Thank you for getting back with the images. I have gone through the MRI & CT images. Salient features of both images are as under:

MRI:
Early onset of bit prominent degenerative changes appreciated in lower three lumbar disc levels. Post surgical unroofing appreciated behind L5-S1 level (due to recent surgery). Modic Type 1 changes are noted at L5-S1 level. However spinal canal is capacious.
....................
CT:
Chip fracture of anterosuperior border of L5 vertebra is noted. Slight irregularity of tip of anterosuperior aspect of L4 vertebra is also noted with fracture fragments in adjacent soft tissue.
.....................

The pain you are facing is most probably due to above mentioned small fracture areas. I would suggest you to once visit hospital and get an appointment for an orthopedic surgeon & a physiotherapist. Orthopedic surgeon will prescribe medication while physiotherapist will guide you exercises to improve the stability of spine & pain.

Feel free to get back for if you have any follow-up query.
Thank You
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Muhammad Ali Rauf 28 minutes later
Are these fractures common after discetomy procedures?

Can you send me screen shot images of the fractures?
doctor
Answered by Dr. Muhammad Ali Rauf 1 hour later
Brief Answer:
Limbus variant; occurs due to degenerative changes

Detailed Answer:
Hello

Thank You for the followup query. These areas are also called limbus vertebra and is a variant. They unlikely occur post surgery. There are prominent degenerative changes in the form of anterior & posterior osteophyte formation. These pointed osteophytes also contribute in pain. The main cause of pain is surgery, followed by osteophytes & limbus vertebra. As mentioned earlier, medical therapy along with physiotherapy can improve the condition and relieve pain.

Secondly, i have marked the limbus vertebra variant in both L4 & L5 vertebra along with pointed osteophytes. Images will be emailed to you by HCM in a while.

If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you speed recovery & good health !!
Above answer was peer-reviewed by : Dr. Nagamani Ng
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