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Old 11-07-2012, 06:59 PM   #1
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central canal stenosis

I've been having low back pain radiating from my spine down my left leg for 3 weeks. The pain is so severe that I'm in tears. I am 33 and bore two children naturally with no pain meds or epidural. This back pain is nothing I've ever felt before-much worse than two natural drug free childbirths!
My left calf and toes are experiencing numbess and loss of strength. After 3 deep tissue massages and 3 weeks of chiropractice care/ stems I finally got an MRI yesterday. The report is alarming, and I'm not sure if this is really something I need to have surgery. I'm a school teacher, and do not like taking pain meds to manage getting through the day. Any advice is appreciated!

Findings:
L4-5 There is disc space narrowing along with disc desiccation and anterior spur formation. Inferior foraminal narrowing bilaterally secondary to lateral disc bulges. Posterior disc protrusion/herniation along with left paracentral disc extrusion/herniation extending slightly inferior to the disc space level into the left lateral recess causing mass effect on the proximal left L5 nerve root. There is facet and ligamentum flavum hypertrophy. There is central canal stenosis. The AP diameter of the thecal sac measures 9.2 mm.

Impression:
Posterior disc protrusion/herniation and left paracentral disc extrusion/herniation at L4-5 resulting in central canal stenosis and left lateral recess stenosis. Disc material extends into the neural foramina bilaterally resulting in inferior foraminal narrowing.

 
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Old 11-09-2012, 09:55 AM   #2
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Re: central canal stenosis

Welcome to the board. As hard as it is to believe, I have written a post to you twice and lost it. I have a new laptop and I'm not sure what happened. The first one was really long and detailed, the second one a day later was shorter...I'm going to try again....First, I mainly post on the back board, but happened to see your post here. There are more people with lumbar issues on the back board so you will find information there, too.

The title of your thread indicates that central canal stenosis is of concern to you. In my humble layman's opinion, I think you'll find that the bad disc at L4-L5 is causing you the most pain.

There are a number of problems at that spinal segment of a degenerative nature...the most significant appears to be the disc extrusion:
Posterior disc protrusion/herniation along with left paracentral disc extrusion/herniation extending slightly inferior to the disc space level into the left lateral recess causing mass effect on the proximal left L5 nerve root.

Many of these words are describing the location of the extrusion....what you need to know is that on the left-central side the disc is pushing out into the left lateral recess, which is a very small "canal" where spinal nerves exit the spinal canal.

Within the spinal canal in the lumbar region, the nerves run across the disc and under the facet joints. This little space is called the subarticular region or the lateral recess. It can become clogged up due to a bulging disc or enlargement of the facet joint, etc. All these things are contributing to pressure on the L5 spinal nerve...which is causing your sciatic pain.

You will also note that there is damage to your facets at this level. They have become enlarged as has the ligamentum flavum. These two things, along with the effects of the bulging disc are contributing to the stenosis that is narrowing the spinal canal. A normal lumbar canal is between 15-23mm on average. It is considered stenotic at 12mm...so yours isn't horrendously impacted but it is enough to cause the symptoms of sciatica that you are experiencing.

I imagine the spine specialist will want to try conservative measures first. These would include a course of physical therapy to strengthen the core and back muscles that help to support the spine, oral medications and perhaps a series of epidural steroid injections. It may turn out that you will need a surgical procedure to decompress the L-5 spinal nerve.

If you should suddenly develop loss of muscle function, like a drop foot, or loss of bladder and/or bowel function, call your doctor ASAP. These are signs of CES, cauda equina syndrome, which is just about the only lumbar issue that is considered a medical emergency, requiring immediate care.

Last edited by teteri66; 11-09-2012 at 10:02 AM.

 
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bleblanc (11-10-2012)
Old 11-10-2012, 06:19 PM   #3
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Re: central canal stenosis

Thanks for your reply. I have not experienced drop foot at this point, but I do have numbness in the left calf down into my toes.
My appointment with a neurosurgeon is in a week.

 
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central canal stenosis, disc herniation, spinal stenosis



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