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What Does This Post Surgery CT Scan Report Indicate?
Question: The patient couldn't move her legs for the past 1 month and spinal problem was diagnosed. The CT and MRI showed nerve pressure in D10 and D11 and an old fracture in L5 which was healed. It also showed some kind of an infection and soft tissues. A biopsy was carried out to rule out TB and Cancer. The results came out negative for both.
Our doctor suggested decompression and fixation surgery of D10 and D11. The surgery was carried out 5 days ago where 10 titanium poly-axial screws and a titanium rod was fitted in the spine. Our doctor described the surgery as successful. During the surgery a sample was taken out of the soft tissue and was sent for biopsy to rule out TB. Initial reports came back negative for TB.
Although post surgery there was not much movement in her legs (sensation and finger movements are possible which was also possible before surgery) and our doctor carried out a CT scan and MRI to rule out blood clotting and also said that the patient might have to go through another surgery to remove the blood clots if any.
We want an opinion on the post surgery CT scan report which I have attached.
Also if you could please explain whether the information of paravertebral soft tissues and hematoma provided is what we should be worried of and we wanted to know whether blood clots are present. No specific back pain is present.
The patient is 72 yo female having diabetes and hypertension since past 15 years and COPD since past 1 year.
Thank you.
Regards,
XXXX XXXXXXX
Our doctor suggested decompression and fixation surgery of D10 and D11. The surgery was carried out 5 days ago where 10 titanium poly-axial screws and a titanium rod was fitted in the spine. Our doctor described the surgery as successful. During the surgery a sample was taken out of the soft tissue and was sent for biopsy to rule out TB. Initial reports came back negative for TB.
Although post surgery there was not much movement in her legs (sensation and finger movements are possible which was also possible before surgery) and our doctor carried out a CT scan and MRI to rule out blood clotting and also said that the patient might have to go through another surgery to remove the blood clots if any.
We want an opinion on the post surgery CT scan report which I have attached.
Also if you could please explain whether the information of paravertebral soft tissues and hematoma provided is what we should be worried of and we wanted to know whether blood clots are present. No specific back pain is present.
The patient is 72 yo female having diabetes and hypertension since past 15 years and COPD since past 1 year.
Thank you.
Regards,
XXXX XXXXXXX
Brief Answer:
Soft Tissue Present. Need for Another Surgery can be decided by Clinical Ex
Detailed Answer:
Hi,
Welcome to HealthCareMagic.com I am Dr.J XXXXXXX Anto Bruno Mascarenhas, and I am here to help you. I have read your question with care and understand your concerns.
Let me address your queries one by one
Q 1 : We want an opinion on the post surgery CT scan report which I have attached.
Answer 1 : The Report says that
a. The Bones are Osteoporotic. This means that the bones have been thinned out due to age
b. Pedicle Screws are present
c. Rod is Present
d. Laminectomy has been done. This means that the surgeon has removed a part of bone to reduce the pressure
e. There is a soft tissue
However the report is not specific what is that soft tissue. The report says that it could be infection or Blood Clot or cancer
Q 2 : Also if you could please explain whether the information of paravertebral soft tissues and hematoma provided is what we should be worried of and we wanted to know whether blood clots are present. No specific back pain is present.
Answer 2 : The Report says that there is a soft tissue and that it could be due to infection, blood clot or cancer. This is a cause of concern and till this disappears, you need to worry.
If it is a cancer, Surgery or Radiotherapy or Chemotherapy or Combination may be required
If it is Infection, medicines with or without surgery may be required
If it is Blood Clot, medicines with or without surgery may be required
Whether Another Surgery is needed or not can be decided only by Examination of the patient after checking for Motor Power, Reflexes, Sensory System in detail in person.
Hope you found the answer helpful.
If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.
Best Wishes for Speedy Recovery
Let me know if I can assist you further.
Take care.
-oOo-
PS 1 : In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at this url http://bit.ly/24GoazT
Soft Tissue Present. Need for Another Surgery can be decided by Clinical Ex
Detailed Answer:
Hi,
Welcome to HealthCareMagic.com I am Dr.J XXXXXXX Anto Bruno Mascarenhas, and I am here to help you. I have read your question with care and understand your concerns.
Let me address your queries one by one
Q 1 : We want an opinion on the post surgery CT scan report which I have attached.
Answer 1 : The Report says that
a. The Bones are Osteoporotic. This means that the bones have been thinned out due to age
b. Pedicle Screws are present
c. Rod is Present
d. Laminectomy has been done. This means that the surgeon has removed a part of bone to reduce the pressure
e. There is a soft tissue
However the report is not specific what is that soft tissue. The report says that it could be infection or Blood Clot or cancer
Q 2 : Also if you could please explain whether the information of paravertebral soft tissues and hematoma provided is what we should be worried of and we wanted to know whether blood clots are present. No specific back pain is present.
Answer 2 : The Report says that there is a soft tissue and that it could be due to infection, blood clot or cancer. This is a cause of concern and till this disappears, you need to worry.
If it is a cancer, Surgery or Radiotherapy or Chemotherapy or Combination may be required
If it is Infection, medicines with or without surgery may be required
If it is Blood Clot, medicines with or without surgery may be required
Whether Another Surgery is needed or not can be decided only by Examination of the patient after checking for Motor Power, Reflexes, Sensory System in detail in person.
Hope you found the answer helpful.
If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.
Best Wishes for Speedy Recovery
Let me know if I can assist you further.
Take care.
-oOo-
PS 1 : In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at this url http://bit.ly/24GoazT
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hello Doctor,
Thank you for the prompt reply.
First to tell you about the patient's status, she has normal sensations in both her legs, can move her toes, if she takes a little effort she can move her ankles too. She still cannot lift or fold her legs or move them sideways i.e cannot move from the waist. Before the operation her legs were rock hard but now after the operation have loosened up. The movement of the legs is the same as it was before operation. No other abnormality is seen till now.
Now regarding the soft tissue, we had a chat with the radiologist and he said that there is definitely something i.e soft tissue, which means it can be an infection or cancer mass or hematoma.
Then we then had a in depth chat with our spine surgeon and he said since the pre-operation biopsy and post operation biopsy both came back negative for an infection (tuberculosis) and cancer those possibilities have to be ruled out.
Regarding the blood clot he said that the CT shows some soft tissues but the patient is not showing any symptoms of blood clots (i.e severe pain in back and legs, swelling at the operated region or burning sensation at the operated region or fever etc). Since it has been 6 days since the operation and no symptoms are present he does not feel it is a blood clot. The doctor also said that going in for a second operation just to check the blood clot is of high risk considering the patient's age and medical history of diabetes and COPD and also because the symptoms are not present.
He also said in his opinion we should wait and watch for any symptoms and continue with the physiotherapy treatment. He further said that a 3 day steroid treatment is being done followed by a anti-inflammatory drug treatment for the soft tissues is to be carried out.
The doctor has suggested for a discharge from the hospital after completion of steroid treatment and anti-inflammation drug course with physiotherapy to be continued at home.
What is your opinion on this line of treatment and our doctor's take on hematoma?
Thank you for the prompt reply.
First to tell you about the patient's status, she has normal sensations in both her legs, can move her toes, if she takes a little effort she can move her ankles too. She still cannot lift or fold her legs or move them sideways i.e cannot move from the waist. Before the operation her legs were rock hard but now after the operation have loosened up. The movement of the legs is the same as it was before operation. No other abnormality is seen till now.
Now regarding the soft tissue, we had a chat with the radiologist and he said that there is definitely something i.e soft tissue, which means it can be an infection or cancer mass or hematoma.
Then we then had a in depth chat with our spine surgeon and he said since the pre-operation biopsy and post operation biopsy both came back negative for an infection (tuberculosis) and cancer those possibilities have to be ruled out.
Regarding the blood clot he said that the CT shows some soft tissues but the patient is not showing any symptoms of blood clots (i.e severe pain in back and legs, swelling at the operated region or burning sensation at the operated region or fever etc). Since it has been 6 days since the operation and no symptoms are present he does not feel it is a blood clot. The doctor also said that going in for a second operation just to check the blood clot is of high risk considering the patient's age and medical history of diabetes and COPD and also because the symptoms are not present.
He also said in his opinion we should wait and watch for any symptoms and continue with the physiotherapy treatment. He further said that a 3 day steroid treatment is being done followed by a anti-inflammatory drug treatment for the soft tissues is to be carried out.
The doctor has suggested for a discharge from the hospital after completion of steroid treatment and anti-inflammation drug course with physiotherapy to be continued at home.
What is your opinion on this line of treatment and our doctor's take on hematoma?
Brief Answer:
The proposed plan of action looks correct. That can be followed
Detailed Answer:
Hi,
Welcome back to health care magic !
Thanks for the update
Since you have ruled out infection and Cancer by Histopathology
the soft tissue can be either inflammation or hematoma
The good news is both can be easily treated with tablets instead of another surgery
Since the patient is better now than how she was before surgery, we need not do another surgery. We can wait and she will improve
About blood clot, even it is a blood clot, it is not causing any problem now. That means it will disappear by itself in few days and no surgery is needed
The treatment which is being done and which is being proposed looks correct. we can continue it and review after few days.
best wishes for speedy recovery
take care
The proposed plan of action looks correct. That can be followed
Detailed Answer:
Hi,
Welcome back to health care magic !
Thanks for the update
Since you have ruled out infection and Cancer by Histopathology
the soft tissue can be either inflammation or hematoma
The good news is both can be easily treated with tablets instead of another surgery
Since the patient is better now than how she was before surgery, we need not do another surgery. We can wait and she will improve
About blood clot, even it is a blood clot, it is not causing any problem now. That means it will disappear by itself in few days and no surgery is needed
The treatment which is being done and which is being proposed looks correct. we can continue it and review after few days.
best wishes for speedy recovery
take care
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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