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DoogleNK
DoogleNK, Doctor (MD)
Category: Health
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Experience:  MD
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I recently had another MRI & it stated abnormal pre & post..scar..l5

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PLEASE HELP SCARED I recently had another MRI & it stated abnormal pre & post with/without the dye also mentioned something about adjacent discogenic marrow edema? this finds exacerbated the presence of circumferential enhancing scar formation about the l5 nerve root @ this same location.also states loss of disc signal,disc space narrowing. I dont have an appt with my surgeon until Monday & i am very scared & nervous on what all this means. More so scared on what this marrow edema is? I know edema is (fluid) So please help me thank u & god bless laura By the way i am only 27 & had previous back surgery in 08
Hi Sir or Madam,
The thing that worries me most is the circumferential enhancing scar around the L5 nerve root. This means the nerve root is trapped in scar tissue formed because of the previous surgery . This may be causing pain/numbness weakness in your leg.
The marrow edema is indeed more water content in the marrow. This just indicates that the marrow is responding an irritation.
The primary problem is entrapment of nerve in scar. Depending on the severity of your symptoms,the neurological exam and severity of entrapment, your surgeon would decide further treatment which may include surgery.
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Customer: replied 5 years ago.
Ok so i do have severe pain have been having the epidural injections doesnt even help their are days i look like im 90 i am not able to get up of a morning without feeling like im dying & people think im just putting on a show! I do have weakness in my left leg and my toes are always tingling & the reason 4 my last surgery was because of severe spinal stenosis. But i was informed that with the scar tissue back there they will not be able 2 do surgery through my back they will have 2 go through my stomach is that true?
Having read the MRI result, I completely believe that you must be miserable.

I agree with your surgeon that he would have to go through the abdomen (stomach). Operating from the back would make it very difficult to identify the nerve roots from scar.

Even though it seems very scary that they will go through your stomach, it is not as bad. In that approach, the surgeon does not cut on your intestines or other organs. Most of the times, they stay completely out of the peritoneum ( a sac in your belly that contains the stomach and intestines) and carefully reach the spine.

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Customer: replied 5 years ago.
Ok so i would have to be really skinny for them to do this then because the one dr told me i was FAT not in a nice way either said that my legs and butt werent big just my belly & that having surgery with a fat belly is not sucessful! is this true as ia m 5ft 8 very stalky & 219lbs but just a belly not flabby either its a hard stomach
A big belly does make the surgical approach more difficult. But, as symptomatic as you are even with the epidural injections, I think surgery may be necessary. And with scar tissue on the back side of your spinal cord, there would be risk of nerve root damage if operated from the back.
So, I think its is still advisable to go through the belly for this surgery.

I would like to clarify that I am an orthopedic surgeon, but I do not do spine surgery.My answers are based on basic training in spine and not extensive experience as a spine surgeon.

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Customer: replied 5 years ago.
Ok last thing before i accept because you have been helpful to me. & i feel a little at ease now may be able 2 sleep a little knowing that i have gotten some answers this evening. But my thing is if they do a spinal fusion will i be able to go back to work as i am a nursing assistant & do a lot of lifting & do you think it is safe 4 me to go back now until i do have surgery because the 1 dr said that i was fat & needed to lose weight before he would even consider me a canidate 4 surgery.
Consider these facts-

Lifting heavy stuff is bad for backs before or after surgery.

Return to lifting work after a back fusion would be very prolonged- basically till the bony fusion has been completed- maybe 6 months.

Weight loss before surgery would greatly help- easier exposure for the surgeon, quicker recovery from surgery, higher chances of successful fusion.

Finally, I do not think one should avoid a back fusion when the alternative is continued misery.
Customer: replied 5 years ago.
I really really appreciate everything that you have done for me this evening i really do thanks so much. Laura
God Bless you.

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Customer: replied 5 years ago.
So after talking to you last night i felt a little better but i am still having concerns and wondering should i consider having surgery soon or if i prolong it will i keep getting worse? thank you again for your time.