Test Results from MRI and EMG/NCV

After being down and out from being sick, I'm finally back to feeling like my old self. :) During my absence, I had a couple more tests done. I actually had two MRIs done as well as an EMG with a NCV. I ended up having to have two MRIs done simply because the first was done without contrast. The results of those test are as follows:

MRI # 1

FINDINGS: There is normal alignment of the lumbar spine. No marrow signal abnormalities are seen. The spinal cord is normal in signal and terminates appropriately at L1. The paraspinal soft tissues are   unremarkable. Lumbar fusion hardware is seen at L4-5 and L5-S1. Local susceptibility artifact limits revaluation of these disc levels. There apprears to be soft tissue in the ventral epidural space at L5-S1 which could be susceptibility artifact or soft tissue. If soft tissue, this may represent residual/recurrent disc herniation versus scar. There is effacement of the ventral space but no significant central stenosis is seen. There is mild bilateral facet osteoarthropathy.

    
IMPRESSION: Status post lumbar fusion L4-5 and L5-S1 with susceptibility artifact from the fusion material which somewhat limits evaluation of the L4-5 and L5-S1 as described above. Soft tissue of the ventral epidural space at L5-S1 could represent residual/recurrent disc herniation versus scar tissue but assessment limited by adjacent susceptibility artifact.

MRI # 2

FINDINGS: There is enhancing epidural tissue at the L4-5 and L5-S1 post discectomy interspaces that
is not exerting any mass effect and some of this is surrounding the right L5 and S1 nerve roots in their respective lateral recesses. The granulation tissue, slightly enhancing, at the site of the previous L5-S1 disc protrusion is unchanged from the recent study and smaller than it was on 6/2012. This is the only area where there is any mass effect. There is no evidence of disc space infection although that is somewhat compromised by the metallic artifact from the intervertebral spacers.  All of the higher lumbar intervals remain unremarkable. No new or different pathology compared to the recent exam. The intervertabral spacers are new compared to 6/2012.

IMPRESSION:

1. Stable or slightly decreasing regions of enhancing epidural soft tissue L4-5 and L5-S1.
2. No new or different pathology compared to the recent study on 02/2013.

EMG/NCV Study

     Summary/Interpretation:

1. The only abnormalities of this study were the absent right and prolonged left H-reflex consistent with chronic S1 radiculopathies.
2. On clinical grounds a mild residual right L5 radiculopathy is suspected.
3. Importantly there was no electrodiagnostic evidence for an acute/ongoing right lumbosacral radiculopathy at this time.

Basically, the neurologist believes the radiculopathy I am experiencing is a result of scar tissue. I inquired about getting a CT myelogram and he advised against it because it is invasive. He believes the pain I have now will subside with time. On the other hand, my orthopedic surgeon wants me to go ahead and get the CT myelogram because the MRI results are inconclusive. Personally, I'd like to know why I'm still experiencing pain in my right leg. So I have decided to get further testing done. I'm scheduled to have the CT myelogram in a couple of weeks. Hopefully, that test will provide some much needed answers.