Orthopaedic Surgeon Questions Radiologist

What does all this mean and what are the treatment options?

I'm trying to understand what my MRI results mean and the possible treatment options. I've had a nerve decompression surgery and lumbar fusion l5 s1 in the last 6 months as well but my problems have just gotten worse which is why I had another MRI done recently in a case that helps at all but here are the things I'm having trouble understanding. Obscuration of epidural fat, lateral recess fat, and right foraminal fat, likely representing postoperative change. Left-sided marginal osteophyte with moderate left foraminal stenosis. Obscuration of fat planes on the right at L5-S1 including the lateral recess and foramen, is likely postoperative change. Moderate left foraminal stenosis at L5-S1. Mild spondylosis at other levels without significant spinal canal or foraminal stenosis.

Male | 31 years old

2 Answers

It means you still have some issues with your spine in the Lumbosacral region. The fat may be post operative but you have bony changes (spondylosis, osteophites) which appear to be narrowing the foraminal canal (where the nerve roots come out). This can cause pain, numbness, weakness. I suggest you sit down with the Dr. that sent you for your MRI and did your surgery and discuss treatment options surgical and non surgical.

Dr. F
....in other words, is sounds like you have developed scar tissue or what's called epidural fibrosis.....a common cause of 'failed back'. At 6 months, your fusion should be nearly complete....IF it happened.....as the name implies, the goal of the surgery is for the bone of L5 & S1 to fuse together into a solid contiguous column of bone.....aka...arthrodesis.....it usually works, but sometimes for various reasons it may not.....obviously, I have'nt seen your images, but those are a couple of common post-op complications to look out for....in addition to recurrent disc herniation.....if you were infected, you'd likely know it...fever etc....
All the best...