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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is severe pain in the right leg and groin signs of a compression fracture?

Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4232 Questions

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Posted on Thu, 24 May 2018 in Back Pain
Question: I have had 3 back surgeries in the past 5 months. I am a 38 yr old and I have alot experience in medical field and need an outside opinion. My first surgery was discectomy, horrific pain when I woke up like I had never had. After 1 week I begged for MRI and epidural was done. No relief. Laminectomy was done day 8 from first surgery. Dr. said the disc space was hardened he physicaly had to break it and chisel out fragments from first surgery is how he described it to my family.. Turns out fragmnents was left behind causing 2nd surgery. I was quickly released within 60 days of his care. Although, still complaining RT leg, RT groinn pain. The stabbing pain was often there bringing me to my knees with severe pain. Another scan done, luckily I am MRI tech
Was able to get it done quickly. Radiologist had seen me working still in pain He read scans results of that appeared to look or mimic osteomyelitis. Labs and bone biopsy completley normal. Cultures nevere gre anything. Only thing was at site surgical for bone biospy the fluid drawn 1250 white cells was only flag. I have had 2 pic lines medication allergic reaction 2 times. Infectious disease team feels NO infection. I feel this was result from 1st surgery. Like a fracture took place and momics the infection they believe I have. I do not feel that. Never been sick, chills, fever any sign. I cant get them to just take a look at it through my eyes. A trauma took place and I am in pain and searching for right answers. Could this be from a fracture that took place originally is my question? On the MRI sag images in oct. Please look at SAG Stir it could be a compression fracture, or trauma to me or infection. Ive gone the infection route and nothing has helped. I have all my scans I would upload for you when you are able to review

Please help
doctor
Answered by Dr. Prof. Kunal Saha 3 hours later
Brief Answer:
Unlikely to have anything to do with the first surgery.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. However, I seriously doubt whether the fracture would have anything to do with the first surgery. Rather, it is more likely to be a compression fracture and is more likely to be associated with the original underlying cause that made you go for surgery in the first place. Nevertheless, if you can upload the report as well as the plate images, I could perhaps guide you specifically on the probabilities.

Could you please give me the specifics of cell type and other details in context of the 1250 white cells you mention. Also specify from where the fluid had been drawn.

I would await your response. Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Prof. Kunal Saha 4 hours later
Thank you. Yes I have all my scans on a disc I thought were uploaded with my story I sent. I will retry and get information about labs. It was drawn at my surgical site L5 S1
doctor
Answered by Dr. Prof. Kunal Saha 31 minutes later
Brief Answer:
Uploading documents is easy

Detailed Answer:
Thanks for writing back. Unfortunately I do not find any attachment. You can upload the attachments using the facility on the upper right of this page. Alternatively you can email the attachments to YYYY@YYYY with the query id 356716 and my name mentioned in the subject.

I would await your response.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha 3 hours later
This is my MRI after first surgery. I will send you the other images when I get home. I have another MRI from oct this yr. a CT lumbar from nov
doctor
Answered by Dr. Prof. Kunal Saha 56 minutes later
Brief Answer:
Neuropathic pain to be considered

Detailed Answer:
Thanks for uploading the MRI.

The encircled area does not look good and is essentially the source of your problems. I am not sure of the surgical scope that was there during the surgery. However, such surgeries can be difficult and the first surgery quite predictably has left the problem unresolved.

Also, I do not consider the residual amounts have been left there intentionally. Please let me know what are you inquiring specifically.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Prof. Kunal Saha 16 hours later
Yes the MRI you reviewed was 6 days out from my discectomy. Then a laminectomy was done and dr removed bone fragments left from first surgery. Pain was better to some degree but never went away. Always felt like something wasn't right. This wasn't normal. Then would get a colleague to scan me and we would go over and over it to ourselves. The dr said it was normal. Post op pain everyone different. Yet still I knew all that but wasn't sure. My right ground pain became more and more. I knew bursitis definitely but my groin pain was just shrugged under. I got to a point my primary ordered me a MRI with and without to see what was going on. Sure enough. I will get those uploaded asap. The images I thought immediately discitis? Infection or fracture. The rad I work with osteomyelitis. He was certain. He referred me to another dr who was neurosurgeon. He knew something wasn't right and had seen me working through pain. As you know MRI tricks we do a lot lifting and moving patients all day. The new dr ordered labs. Normal plus CT lumbar which a diff rad read. Osteomyelitis. Ok. Well after bone biopsy plus more labs only thing abnormal was fluid drawn from site of surgery. The 1250 white cells. That has been the one and only time anything abnormal. That was nov 13. Since I have had labs. Normal. Infectious Dx dr confused Bc they see no indicators that point to infection. I have had 2 pic lines and round of heavy antibiotic andcreations after 2 weeks in. Vancomycin daptomycin. Ceftzadine. I have since had an ALIF with posterior screws for stabilization. That has done wonders. But neurosurgeon still feels infection. Why?he said didn't like wAy bones looked ok. Well hell me either only thing he is basing this on is what images look like. Infectious Dx dr still are pure guessing. Grasping they don't feel like it is.
My question is once I get rest scans loaded for you. Could it be possible this all stemmed from failure discectomy? That collapsed or fractured. Mimicking an infection??
I need other opinion besides dang osteomyelitis Bc I've not had 1 symptom fever chills sweats nausea during this 6 months to indicate infection

Please have any other ideas?
doctor
Answered by Dr. Prof. Kunal Saha 6 hours later
Brief Answer:
Looks like a collapsed vertebra. Get a second opinion from an orthopedic

Detailed Answer:
Thanks for writing back. I understand that you are having a difficult time trying to explain the radiculopathy or neuropathic pain that you are experiencing. It can be due to a collapsed vertebra but it is unlikely to have stemmed from a failed discectomy. I am not certain that there is a infective cause likely. Osteomyelitis is a probability to consider although I doubt whether that is actually the case.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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