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What Does This MRI Report Of Spine Indicate?

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Posted on Sat, 18 Oct 2014
Question: I've been told my metal work has moved this is scan report can you explain?MRI Spine Lumbar/Sacral : There is metalwork in the L5 andS1 vertebral bodies, with sclerotic changes around the corresponding vertebral body endplates.
At the L5/S1 level, there is a central disc protrusion, just contacting ventral
surface of thecal sac. On the T1-weighted images, there is some
an additional soft tissue around the left S1 nerve root
within the lateral recess. Gadolinium has not been given on
this occasion, but comparison with the previous gadolinium
enhanced MRI examination November 2013 confirms this to be enhancing epidural fibrosis.
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (32 minutes later)
Brief Answer:
it shows that you are developing fibrosis

Detailed Answer:
Hello,
I have studied this report and it has following points.
1. Your metal work is in same position.
2. There is more fibrous tissue then previous MRI but it is not a big issue as it can be due to healing.
3. There is mild disc compression and root compression.
I would also want to tell you that MRI in the presence of metal in the body is not very good. It some time gives a false report.
Before I advise you any further I want to know few things.
1. When was your first surgery done ?
2. What was the Indication for that?
3. What are the symptoms now ?
Please send me answers of these questions. I will try my best to help you.
Thanks
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr. Naveen Kumar Sharma (3 hours later)
I had CES in L5S1 in sept 2012 surgery was delayed and I am left with foot drop I self catheterise. A partial but huge discectomy was done with some remaining disc. Re herniated and a fusion with cage, bone graft and plates February 2013. Never regained bladder control or use of left leg. MRI was performed because of increased pain, weakness and numbness. As well as the report I was sent an appointment for CT to assess movement of hardware. I am in a considerable amount of pain struggling to move or sleep and am worried because of previous Cauda Equina Syndrome. 60mg zomorph morning and night. Also Diazepam amytripiline severedol Here is the full scan report.

Clinical Details:

Cauda Equina since 2012 and lt sided weakness and foot drop
Now complaining of new symptoms of right sided weakness

?spinal cord injury

MRI Spine Lumbar/Sacral : There is metalwork in the L5 and S1 vertebral bodies, with sclerotic changes around the corresponding vertebral body endplates. Elsewhere, vertebral body and disc height is well-maintained and discs well hydrated.

There is a mild diffuse disc bulge at L3/4 extending slightly more to the left side, but no compression of thecal or exiting nerve roots. No significant thecal sac or nerve root compression is seen at L4/5. At the L5/S1 level, there is a central disc protrusion, just contacting ventral surface of thecal sac. On the T1-weighted images, there is some additional soft tissue around the left S1 nerve root within the lateral recess.
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)
Brief Answer:
I think you might need a repeat surgery

Detailed Answer:
Hello,
I have studied your reports and I think that your plate and screws are not serving their function. This is not because screws are loose but it is because fusion is not occurred or graft has failed. Movement at surgery side is causing herniation and pain.
I am afraid you might need a repeat bone grafting. Screws and rod might need a change also. It will be a big surgery and should be done by an expert who can handle such revision surgeries.
I hope this answer will be helpful. Let me know if there is any other followup questions.
Thanks
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

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What Does This MRI Report Of Spine Indicate?

Brief Answer: it shows that you are developing fibrosis Detailed Answer: Hello, I have studied this report and it has following points. 1. Your metal work is in same position. 2. There is more fibrous tissue then previous MRI but it is not a big issue as it can be due to healing. 3. There is mild disc compression and root compression. I would also want to tell you that MRI in the presence of metal in the body is not very good. It some time gives a false report. Before I advise you any further I want to know few things. 1. When was your first surgery done ? 2. What was the Indication for that? 3. What are the symptoms now ? Please send me answers of these questions. I will try my best to help you. Thanks