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Old 04-13-2007, 01:24 PM   #1
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Question MRI Results and My Symptoms, PLEASE HELP!

I know this may be alittle long but the majority of it is the MRI FINDINGS. Please sit back, relax if you can, have a cup of coffee, and then pleasantly leave some feedback please.

Resently I had a consultation with the a Neurosurgeon.We reviewed the MRI photos but he did not review the findings from the Radiologist. He insisted that my symptoms are not consistant with the MRI photos. Isn't this why the Radiologist gives the findings insted of the Neurosurgeon interpreting the photos? It like the Neurosurgeon didn't care what the Radiologist had to say.

MRI RESULTS: At L1-L2, there is desiccation of the disk, with some mildto moderate loss of the disk space height. L4-L5: Desiccation and some decrease in height of the intervertebral disk is demonstrated. There is a diffuse disk bulge with superimposed moderately-sized central protrusion. There is stable moderate circumferential bulging of the L4-L5 and L5-S1. There is moderate to neural forminal stenosis at the left L4-L5 and L5-S1 levels. There is moderate to severe right L4-L5 and severe L5-S1 neural foraminal stenosis. L5-S1: There is desiccation and mild-to-moderate loss of height of the intervertebral disk. A broad-based disk bulge with superimposed moderately-sized central protrusion is noted of the disk bulge and the protrusion and then onto the thecal sac but do not cause any significant spinal canal narrowing. IMPRESSION: 1. Second sacral element small likely hemangioma with blood products. 2. Degenerative disk disease and degenerative joint disease at L4-L5 and L5-S1. The abnormal L4-L5 disk may contact the transiting left L5 root.3. Degenerative disk disease at L1-L2 with some associated disk height loss. No significant neural foraminal narrowing or spinal canal stenosis is appreciated at this level.

MY SYMPTOMS are constant tingling to the outside of both my calves down to my little toe and to my big toe on both feet when sitting or standing to long. It also occurs when I am laying down in bed. He says my symptoms are not consistant with what the MRI Photos are showing him. He never reviewed these finding with me that the Radiologist posted. Symptoms X 1 month now.SUGGESTIONS.

Last edited by dontevergiveup; 04-13-2007 at 01:40 PM.

 
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Old 04-13-2007, 02:02 PM   #2
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Re: MRI Results and My Symptoms, PLEASE HELP!

WEll first of all the surgeons don't usually look at the radiologist report. They are surgeons and they spent all the time in college way more than radiologist. From what I heard the neurosurgeons go to school seven years more than a regualr surgeon. However, we should all get two or three opinions and not go off what just one surgeon says.

It sounds like maybe they should do some more tests like catscan, flex/ext xrays discogram emg's. You might consider checking out dermatone charts to see what disc relates to different nerve pains etc, it really helps you know you aren't loosing your mind.

One thing I have found is that you have to be your own advocate to finding help. If one doesn't listen, find another one. Ofcourse they usually try conservative treatments like pt, injections etc.

It def sounds like you have DDD, I would be most worried if you do have a nerve impinged.
best of luck vette

 
Old 04-13-2007, 02:11 PM   #3
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Re: MRI Results and My Symptoms, PLEASE HELP!

Hi: I like your screen name!! Can you get a second opinion? If your insurance will pay for it, I would do that.

I'm not a Dr so I can't tell you exactly what the problem is between the two differing opinions, but I've seen many neuro and ortho surgeons and all of them would *only* look at the films not the report. I've also had many say to me bring the films only I don't want the report. The only Drs that ever paid any attention to the reports were Drs that weren't surgeons. Like my Endo, and primary care Dr will read the reports and go by the radiologists findings but I've never met a surgeon who will and I don't know why. The only reports my surgeon will read are the ones without films-like EMG's or Myelograms.

I'm not sure what the deal is between radiologists and surgeons, but the surgeons seem to think that they will decide, from the films, what's going on.

Do you have any back pain, or is it just your legs?


Sorry I can't help, but try to find someone that will at least tell you what's going on and what you should do about it. Good Luck

 
Old 04-13-2007, 03:51 PM   #4
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Re: MRI Results and My Symptoms, PLEASE HELP!

Hi D-ever-g-up,

Welcome.

I agree with Vette & Des, none of the surgeons I have seen took the time to read the MRI report. Even another radiologist would want to see the films and not read someone elses interpretation of the films. The neuro-surgeon is looking at the films from a surgeons point of view. Tingling in the legs and feet could be from allot of things that are not even related to a back problem. Allot of diabetics for example might have simlar symtpoms. Are you in pain? Did you have an injury?

Take care, Chris

 
Old 04-13-2007, 04:07 PM   #5
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Re: MRI Results and My Symptoms, PLEASE HELP!

Just wanted to add. I didn't have any nerves impinged but had lots of nerve problems. When they told me I didn't have nerves impinged, I was like yah right!! I had lots of symptoms nerve pains like needles, burning, aching, throbbing, knives and tingling. All varying and moving...I thought I was going crazy it was hard to even explain at one point it would change every few seconds. But, my surgeon wasn't surprised at all. I have/had severe ddd and spondy. Those dermatone charts are really informative, hope you get a chance to look at them.

 
Old 04-13-2007, 04:29 PM   #6
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Re: MRI Results and My Symptoms, PLEASE HELP!

I agree with the others. My spinal surgeon puts the x-rays up, looks at them, discusses them with me, and if it is a new picture he will say lets see what the radiologist has to say about them. We will go over the report and he will say I agree or don't agree. He takes the time to review them with me and answer all of my questions.

I am not a doctor but according to the dermontone nerve charts, your pain appears to fit with your MRI findings.

My two cents would be to seek another opinion from a spinal surgeon or neurosurgeon.

Good luck.

 
Old 04-13-2007, 04:46 PM   #7
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Re: MRI Results and My Symptoms, PLEASE HELP!

Hi and welcome to this board. It is NOT UNCOMMON for specialists to not read the radiologists report, and/or skim them, or conflict with the radiologists impressions/comments when they do. They like to draw their own conclusions and not have someone else's opinion influence what they see. This is a good thing actually.

What exactly did the neuro say to you.. is he/she going to do more testing, etc? Either way.. you have pain and it's coming from somewhere and you have quite a few things going on there.. however mild they may be at this time. Are you now just in limbo.. do nothing or is there a strategy/plan from the neuro?

If it were me and you are just in limbo.. I would either call the neuro back and get in there and talk about things, or get another opinion right now and not return to this one.

My doc conflicted with the findings of my MRI.. and my MRI's never showed the true problem to begin with. I had a badly blown disc above a bulging one, and 4 surgeons all thought the bulging disc was my problem. Upon doing a discogram by the last surgeon.. he found the blown disc.

Hope this helps in some way for you. Hang in there.. don't get frustrated.. use this as a learning tool for educating yourself more about your back and make sure you getting what you need out of your doctors.. like communication. If you dont have this.. you need to find one you do have this with. This is an essential element to getting the right care for YOU! all the best. hang in there.
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L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 04-13-2007, 04:50 PM   #8
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Re: MRI Results and My Symptoms, PLEASE HELP!

There is also some overlap in dermatomes so you may have to look at the adjacent ones.

I like the idea of a second opinion.

I do have a bit of a medical background and one thing I can truthfully say, Reading MRI's and such does have a subjective component. I have heard many times "The Radiologist over-read the X-rays" or "the Radiologist missed that".

I like the idea of different but supporting test.

These guys, both neuro and ortho that work on spines are the highest paid and therefore the best of the best as far as education and smarts. They have an ego to match. They do make mistakes, however.

 
Old 04-13-2007, 04:54 PM   #9
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Re: MRI Results and My Symptoms, PLEASE HELP!

[QUOTE=yvette777;2919776]It sounds like maybe they should do some more tests like catscan, flex/ext xrays discogram emg's.

Ofcourse they usually try conservative treatments like pt, injections etc.

best of luck vette[/QUOTE]

Vette
Thank you for your response.

I have had seven Epidural injections, Chiropractic work, traction, accupuncture, EMG just last week, and now next week I will have a discogram done with 2 more epidural in L4-L5, and L5-S1. This has been going on for some time now but since I have been deployed to Baghdad, Iraq, I can not get Epidurals there. So they sent me home to get surgery. Well I have been back for 3 weeks and I am still dealing with the same pain. I had an epidural before I was deployed but that only lasted 2 months. So eventually when that work off i started getting tingling in my calves. I had no clue what that meant so I dealt with the tingling. Then it got worse. Wher I always had tingling. Several months passed and it eventually led to shooting left leg pain, like electrical shock to my left leg. That got umbearable so they sent me back after getting an MRI. Tuesday, 17th of April I will get two more epidurals. The doc said it should take the tingling away. We will see. WHY NOT JUST DO A MICRODISECTOMY?
Thanks again for your reply

 
Old 04-13-2007, 05:04 PM   #10
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Re: MRI Results and My Symptoms, PLEASE HELP!

Jack24, Justoneofus, and 123dietdrpepper (LIKE THE NAME)............ thank you so much for replying. I have asked for a second opinion and now have to wait till April 26th for that consult. I have looked at a dermograph and I agree with why I am having tingling and numbing in my lower legs and feet. The one painful thing is the shooting pain down the left leg. MAN THAT HURTS.
VETTE Said:
"All varying and moving...I thought I was going crazy it was hard to even explain at one point it would change every few seconds." That is what I thought at first too when I started having all this tingling.
Thanks for all your opinions and factual information. I appreciate all feedback as I learn more about what is going on with my back and nerves.

 
Old 04-13-2007, 05:15 PM   #11
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Re: MRI Results and My Symptoms, PLEASE HELP!

Why not micro "d" right away? Because you may not be severe enough for them to consider surgery, even though you are in great pain. And, they want to avoid surgery on you if they can. And that is the right approach. There is no sure fire cure for back pain. While back surgery has come a long way just in the last 10 years.. alot of spine issues are still a mystery to us. My doctor said to me.. "my job is to do the very best surgery I know how, and the healing is up to you and the powers that be". Very honest/true statement to make. There are no guarantees.

You have to try as much conservative therapy/treatment as you can before surgery is even considered. Once they cut.. you can't take it back. And it might not solve your problem.

Hopefully you will get some much needed relief from the next injections. These are usually done in a series of 3, spread out weeks apart, for maximum effect (if any).

Welcome and please let us know how you are doing.
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"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 04-13-2007, 06:21 PM   #12
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Re: MRI Results and My Symptoms, PLEASE HELP!

Hi NevGup: I agree with just1ofus, you never want to rush into surgery until you've exhausted all the conservative approaches. I'm very happy you're having and have had all those other tests, because those should pinpoint the problem.

Hopefully with these tests results you'll find out exactly what's going on!! There are way too many of us who have had more than one surgery, because the first didn't totally relieve the pain, or something else went wrong after surgery from weakening. Unfortunately having a surgery *can* weaken different areas of the spine, and you don't want to add more probs to what you already have.

I know how hard it is to wait, especially in your situation, but sometimes waiting gives you a chance to heal without surgery.

Are you stationed in WA? If so, I like to recommend Univ. Hospitals since the Drs there are top in their field and "sometimes can" surpass the best spinal specialist. If you are on a strict time line with your division, can't a Dr take that into consideration and give you special consideration? I see many military people at my Pain Mgte Dr. and they get their treatments each time they are sent back to their home base or if gone long then they have a second Dr. I live in an area with many bases, and they all feel the same way; they would try anything before considering surgery. Also do you have to get medical care from the military, like at Madigan Army Medical Center? If so, can you also see a Dr outside of that, or are you strictly limited to it?

What would happen to your status if you had to take 6 mos to a year off? Sorry I don't know much about the military except for the family members that are in it, and you all deserve a great deal of [U]thanks and appreciation[/U].

Good luck with all of this and we'll all pray for your speedy recovery and a answer to your treatment options.

Last edited by DesertBloom; 04-13-2007 at 06:26 PM.

 
Old 04-14-2007, 02:15 AM   #13
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Re: MRI Results and My Symptoms, PLEASE HELP!

The way I see it, the radiologist merely interprets the scans/xrays, perhaps with some insight into the problem from what you or a referring doctor says.

The neurosurgeon on the other hand will match clinical symptoms to what he sees on the scans. They are rarely interested in the reports themselves which will list a whole bunch of incidental findings, aswell as, one hopes, the real cause of our pain.
I like to think of it as the radioologist just describes the photo but isn't experienced in going in there and seeing it for himself. You know, if you were buying a house, you wouldn't trust everything you saw in the photo and the agents description, you'd speak to someone who knew the area/street then take a look for yourself.
My radioologists were all concerned about my large herniated disc, whereas in fact, as the surgeon had said all along, the small disc herniation wasn't the problem at all.
Hope you find an answer soon
Jinks

 
Old 04-14-2007, 07:07 AM   #14
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Re: MRI Results and My Symptoms, PLEASE HELP!

Hi Don't,

You might be better off getting a second opinion. NOw I am certainly not a doctor and don't even work in the medical field; however, since I've had my sciatca, i've been doing alot of reading up on medical sites, etc. I had found something called a dermatome map, which shows all the spinal vertebrae & discs and their corresponding named numbers (L1, L2, L3, L4, etc...). I've been reading consistently the same thing that is seems the symtoms you describe might correspond with L5 and/or S1 nerve root compression. I personally have sciatica plus pins & needles that start from my outer mid calf and runs all the way down the side of my ankle and into my toes. I also get the sharp, stabbing sciatica pain all into there. I also get bouts where my ankle, entire outer part of my left foot, and some of my toes are completely numb. (which sounds a bit similar to your situation) Are you having any sciatic pain at all?

I havent actually seen a doc yet to diagnose my sciatica (or to find out exactly what's causing it)....but my Physical Therapist even told me that a disc herniation in the L5 or S1 level sounds most likely what it could be.
Again, I'm NOT a doctor, I am just stating my thinking as relates to things I've been researching. So I'm thinking, if you can, you might want to look for another opinion...

 
Old 04-14-2007, 10:57 AM   #15
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Re: MRI Results and My Symptoms, PLEASE HELP!

Well that is good they are doing a discogram, that should clear some things up!!! Ofcourse they don't like to do surgery, it seems like you've already been through the loop of conservative stuff. I do understand When I first herniated my discs way back 17 years ago, I begged the guy to do the surgery..he refused because of my age 19.

I hope they get somewhere with your new tests.

The cause of mine turned out to be Degenerative Disc Disease and Spondyolthesis. Since my surgery five weeks ago my leg/foot things are 95 percent gone....and hope it stays that way.

You might ask about meds for nerve pain, when this was going on with me, I had read on here about nerve pain meds, and went in and asked for cymbalta and neurontin. The doctor's like that's a good idea. Why did I have to ask, they are the damn doctors. Anyway it did help, the other meds don't work for nerve pain like vicodin etc.

Wish you the best of luck. vette

 
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