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What Does This CT Scan Report Indicate?
Question: laminectomy L4-5. 1/12 years ago.
Lower back pan is worse and pain, throbbing, shooting pain, numbness and tingling from left buttocks through hip, worse at thigh, radiates down to calf and through toes and ball of foot. New Ct scans shows;
At L5 level the tips of the screws DO extend beyond the anterior cortical margin of the L5 vertebral body.
What does this mean? And why is pain worsening after surgery? All symptoms are the same as before surgery
Lower back pan is worse and pain, throbbing, shooting pain, numbness and tingling from left buttocks through hip, worse at thigh, radiates down to calf and through toes and ball of foot. New Ct scans shows;
At L5 level the tips of the screws DO extend beyond the anterior cortical margin of the L5 vertebral body.
What does this mean? And why is pain worsening after surgery? All symptoms are the same as before surgery
Brief Answer:
Screws are not likely to cause the nerve root compression.
Detailed Answer:
Hello,
Thanks for posting your query.
The extension of screws beyond the vertebral body can cause an irritation and pain but are not likely to compress the nerve roots causing the persistent pain that you are having. The screws are fitted away from the spinal canal.
There can be nerve compression or lysthesis post fusion that is causing the symptoms.
There is also a possibility of discitis, which can be confirmed by MRI with contrast or CT myelogram.
For these symptoms analgesic and neurotropic medication can be started.
Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.
Physiotherapy like ultrasound and TENS therapy will help
I will advise to check your vit B12 and vit D3 level.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Screws are not likely to cause the nerve root compression.
Detailed Answer:
Hello,
Thanks for posting your query.
The extension of screws beyond the vertebral body can cause an irritation and pain but are not likely to compress the nerve roots causing the persistent pain that you are having. The screws are fitted away from the spinal canal.
There can be nerve compression or lysthesis post fusion that is causing the symptoms.
There is also a possibility of discitis, which can be confirmed by MRI with contrast or CT myelogram.
For these symptoms analgesic and neurotropic medication can be started.
Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help.
Physiotherapy like ultrasound and TENS therapy will help
I will advise to check your vit B12 and vit D3 level.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
All this pain was prior to any surgery. Did PT, pain management and i have a TENS machine that i use daily. After about 2 years, I had a discetomy to clean the disc up. The sypmtoms got worse. I never had lower back pain before. Now, i cant sit for longer then 10 minutes without pain in my lower back. Thats when dr did another mri and found a scattered disc at L5. Thats when he went back in and removed the disc completely. And replaced it with a spacer that had 4 screws attached.
The nerve pain is getting worse everyday. The sciatic pain, throbbing in thigh and shooting pain through leg and foot. If there is nodisc, how could I be in such pain? after 2 surgeries.
The nerve pain is getting worse everyday. The sciatic pain, throbbing in thigh and shooting pain through leg and foot. If there is nodisc, how could I be in such pain? after 2 surgeries.
Brief Answer:
Ct myelogram can help in diagnosis.
Detailed Answer:
Hello.
Thanks for writing again.
After the removal of disc there should not be any pain if the spacer and screws are intact. A CT myelogram can help in detecting if there is any nerve compression still present and at which level. Till then pregabalin and gabapentin with methylcobalamin supplements can help you in overcoming this nerve pain.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Ct myelogram can help in diagnosis.
Detailed Answer:
Hello.
Thanks for writing again.
After the removal of disc there should not be any pain if the spacer and screws are intact. A CT myelogram can help in detecting if there is any nerve compression still present and at which level. Till then pregabalin and gabapentin with methylcobalamin supplements can help you in overcoming this nerve pain.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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