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Suggest treatment for post surgery fibrotic spots

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Posted on Mon, 11 May 2015
Question: Do you know what these spots are in the dura of a lumbar sacral MRI
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Answered by Dr. Erion Spaho (54 minutes later)
Brief Answer:
Probably post surgery changes.

Detailed Answer:
Hi, I have gone through your question and understand your concerns.

Those bright spots on dural layer seem to me like post surgery fibrotic spots.

I'm curious to hear the Radiologyst answer of MRI.

This should be discussed with your treating Doctor, as he knows your condition better than any other, and can have a precise opinion, because he can correlate surgical procedure with MRI findings.

Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Erion Spaho (1 hour later)
Funny, not mentioned on the radiologist report. Could these nerves have been stretched at the L4/L5 level and this sacrum area was the breaking point? I had no surgery in the area in the pictures.
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Answered by Dr. Erion Spaho (1 hour later)
Brief Answer:
Stretching very unlikely.

Detailed Answer:
Hi again.

Nerve stretching is very unlikely to happen during minimally invasive spine surgery.

From MRI, there is no evidence of intradural ( inside the dura) manipulation.

As I mentioned before, these issues can be clarified better by your Surgeon, because he knows better than anyone your condition.

Hope I helped you. Wishing you good health.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Erion Spaho (3 days later)
The surgeon did a lamioforamnotomy at L5/S1 and L4/L5. But I had my lamina removed on the left side of L4/L5. He ended up tearing my dura at L4/L5 an 1.5 centimeter tear. He repaired that but I had to go in for full open back surgery to repair the leak which had grown inside. I wonder if this is some type of intradural cyst, I will have to get a second opinion.
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Answered by Dr. Erion Spaho (2 hours later)
Brief Answer:
A second opinion is always a good thing.

Detailed Answer:
Hi again XXXX.

I agree with you, a second opinion by a Neuroradiologist about post operative MRI findings is a good thing and could clear things up.

Please let me know about next MRI interpretation.

Best regards.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4266 Questions

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Suggest treatment for post surgery fibrotic spots

Brief Answer: Probably post surgery changes. Detailed Answer: Hi, I have gone through your question and understand your concerns. Those bright spots on dural layer seem to me like post surgery fibrotic spots. I'm curious to hear the Radiologyst answer of MRI. This should be discussed with your treating Doctor, as he knows your condition better than any other, and can have a precise opinion, because he can correlate surgical procedure with MRI findings. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.