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Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience:  Working as a Doctor who Cares since 2001.
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my wife had operation for spinal stenosis twice first of gave

Resolved Question:

my wife had operation for spinal stenosis twice first of gave relief for 3-4 years 2nd operation without any relief
surgeon says there are cyst formation post operatively causing pain
need epidural injections if not relieved need surgery third time
please advise
Submitted: 3 years ago.
Category: Medical
Expert:  Ken replied 3 years ago.
Hello,

I am Dr Ken and I will be helping you today.

Was MRI obtained after the surgery to look for the cause of the pain?
Customer: replied 3 years ago.

yes MRI was obtained and it reveal small cyst formation at the place of operation


surgeon want to give spinal injection first and if no relief of pain wand to operate again

Expert:  Ken replied 3 years ago.
Syed,

I assume contrast enhanced MRI was obtained.

Post-operative pain in lumbar spine is due to pinching of the nerve. The cause is formation of fibrosis/ formation of granulation tissue/ cysts pinching the nerve or rare causes like infection/ trauma, extra.

In your case if the cysts are small than they are less likely to cause compression of the nerve. The steroid shots reduce inflammation of the irritated nerve and thus give relief. The relief may stay for 3 to 12 months. You may again need a shot.

If MRI shows fibrosis or granulation tissue around the surgery site than it will have to be removed by a repeat surgery.

Next step - Steroid shot is a good option. If you get relief than surgery will not be needed. I agree with your surgeon.

Best
Customer: replied 3 years ago.

I just want to know on 1st occasion of surgery he put some screw to stabilise spines on 2nd occasion he did not


is this the reason of cyst formation

Expert:  Ken replied 3 years ago.
During first operation the posterior parts of the vertebrae {laminae} are cut - Laminectomy. This causes a need to put screws and stabilize the spine. During second operation there is no need to put the screws again as the screws are already in place. This is not tha cause for cyst formation too. The exact cause of cyst formation is not well understood. Multiple theories state causes like - Degeneration/ trauma and infection as possible causes.

Best
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