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What do my MRI scan test results indicate?

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Posted on Mon, 23 May 2016
Question: Hello and thank you -
Back in 2008, I had a laminectomy to remove a schwannoma from inside my spinal column. The neurosurgeon said that he extracted 99% of the tumor. It caused nerve damage to my left leg and so I have chronic pain, although I have learned to mange it, favoring my left side, by putting my weight on my right side whenever I stand or sit. I have an MRI every year and the most recent, a few days ago,, said that "there is no residual or recurrent mass within the thecal sac" I am assuming that means the tumor is negligible, or perhaps gone(?)
For the past 6 months i have had increasing pain in my mid to lower back, mostly on might right side, and my guess is that was due to the additional pressure on my right leg. an xray showed spinal spondilothesis at L4-L5 and an MRI was ordered to take a further look as well as check the status of the tumor
The MRI also said that "there is a mild to moderate degenerate anterolisthesis of L4-L5, increased since the prior exam with a moderate loss of height and desiccation of the L4-L5 disc. Conus medullaris is normal. Post surgical laminectomy defects are present at L3-L4. There is some thickening of the nerve roots within the thecal sec at the L4 and L5 level level suggesting arachnoiditis, unchanged and does not show any abnormal enhancement.
L4-L5 : Moderate to marked diffuse pseudodisc bulge causing mild mass effect upon the thecal sac without central canal stenosis. However it does result in a moderate to marked degree of bilateral foraminal stenosis. This has worsened since prior study."
Help! What does all of this mean and do I need surgery?
Thank you so much
doctor
Answered by Dr. Erion Spaho (47 minutes later)
Brief Answer:
Further examination needed.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

The good news is that there is no evidence of tumor, so, we can say it was treated correctly.

Your symptoms seems to be related to spondylolysthesis, and there is need to evaluate it further by x-rays of your lumbosacral column in neutral, flexed and extended position (dynamic x-rays) before to decide if there is need for surgery or not.

Another aspect to evaluate is the contribution of arachnoiditis in your symptoms.

I suggest you to discuss with your treating Doctor about evaluation of the spondylolysthesis degree, and to have a treatment trial with corticosteroid drugs about arachnoiditis, before evaluation of the surgical procedure.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4327 Questions

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What do my MRI scan test results indicate?

Brief Answer: Further examination needed. Detailed Answer: Hello and thanks for using HCM. I have read your query and understand your concerns. The good news is that there is no evidence of tumor, so, we can say it was treated correctly. Your symptoms seems to be related to spondylolysthesis, and there is need to evaluate it further by x-rays of your lumbosacral column in neutral, flexed and extended position (dynamic x-rays) before to decide if there is need for surgery or not. Another aspect to evaluate is the contribution of arachnoiditis in your symptoms. I suggest you to discuss with your treating Doctor about evaluation of the spondylolysthesis degree, and to have a treatment trial with corticosteroid drugs about arachnoiditis, before evaluation of the surgical procedure. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.