MRI advice

teteri66

You are correct. You do need some help. I am curious why your orthopedic doctor referred you to a neurosurgeon. Was he not an orthopedic spine surgeon? Orthopedic spine surgeons receive almost identical training as neurosurgeons when it comes to the spine. Sometimes they take a slightly different approach to the same problem and it is always helpful to get an opinion for each when one is contemplating surgery.

Regardless you do need to see a spine specialist/spine surgeon because you have some issues that need to be addressed.

The feeling of a strained hamstring is often the only sign a person gets when a lower lumbar disc is herniating. That was the case with my husband.

I will try to go through your MRI and point out the "highlights," trying to explain the terminology so when you see the spine specialist, you will be able to converse with him or her.

First, the good news: the lower thoracic area looks good and there do not appear to be problems and the first two lumbar areas, L1-L2 and L2-L3.

At the next level, L3-L4 and again at L5-S1, the discs are extruding. When a disc bulges and goes beyond its disc space, and when some of the disc material breaks through the disc wall, it is considered extruding. The disc material has broken through the annular wall, which is the outer layer of the disc, but it is still attached. If it were to break free, it would be a disc sequestration.

This disc material is pushing out into the central canal and causing moderate compression. Also, in the associated foramen, there is also what should be open space that is being blocked by this extruding disc material. The foramen are openings through which the spinal nerves pass from the spine out into the body. These are the two main areas where nerves can become compressed. it is this compression that results in the radiating pain we feel that goes into our legs and feet or upper limbs if it is a cervical problem.

At L5-S1 the same thing is going on but the extrusion seems to be affecting the left foraminal opening more than the central canal...but it is causing stenosis in both areas. This material is noticeably pushing into both the S1 and L5 nerve roots. This is probably where the worst of your pain is coming from.

If you enjoy doing a little research, look online for a "dermatome map." This will give you an idea of which spinal nerves innervate which area of the body.

When a nerve is compressed, pain can be felt at the point of compression in the spine, or it can cause pain at any point along the pathway of the nerve. My stenosis caused horrid leg pain and numb feet, but I hardly had any back pain.

So basically the discs from L3 to S1 are showing signs of degenerative change, which is causing stenosis in the central canal and some of the foramen. At L5-S1 we know for sure that the spinal nerves are being "squished" as it is apparent on the imaging. Chances are, that the disc extrusion at L3-L4 is also causing issues that are contributing to your pain.

I would imagine the spine doctor will want to try conservative treatments first, such as a course of physical therapy, oral medications and a series of epidural steroid injections (ESI) to try to shrink up the disc extrusion and inflammation.

Your mother's experiences with surgery point to the necessity of finding the very best spine surgeon that is available to you...and if surgery is ever recommended, take the time to get several opinions.

One side note: anyone that has lower lumbar problems needs to be aware of the symptoms of "cauda equina syndrome." These include sudden loss of muscle, such as a drop foot that comes on suddenly, and the loss of bladder and/or bowel control. If any of this happens to you, call your doctor ASAP or go to the emergency room. Cauda equina issues are just about the only true medical emergency when it comes to the lumbar spine. The compressed nerve must be decompressed quickly or the risk of permanent damage is high. This does not happen often, but all of us with lower lumbar problems need to be aware of the symptoms just in case....

Good luck. Please let us know how you progress and what you learn when you do get in to see the specialist.

AndreaS84

Well, I changed my PCP and saw a regular family practice physician Friday. I was so glad when she came in, listened to me, took one quick look at my MRI and agreed I needed HELP!

Just hearing that was such a relief, I've been haggling with my old PCP's office for two days, having to call them to remind them to d/l my MRI report so they could get my referrall started to the neurosurgeon for my "possible" herniated dics. When she said that I raged, it's not possible IT'S VERY REAL and if you had an inkling of how much pain this is then perhaps there would be some light lit under your butt.

So I called my insurance company this morning to get the referall straightened at the neurosurgeons office. It was so dissapointing to be turned away last week after their website said "no physician referral" necessary. On top of that one very rude front assistant came out and explained to me like some ignorant child "look if we don't get that we don't get paid", meanwhile I call my insurance company and they tell me that's not true. I have 60 days to get a proper referall anyway from my PCP. With the MRI I had and an old order for an orthopedic surgeon you'd think they would see me. I mean they verified my insurance. That assistant lied to me multiple times

I can't wait to go in Wednesday go in and proceed to make her time there a living hell. I even got so much rudeness from her on the phone just calling to see if they had put the referall in or gotten my e-mail of my MRI, her first reaction was "we don't normally give out our e-mail how did you get it" instead of just CHECKING the e-mail for my MRI.

update Wednesday.

AndreaS84

[QUOTE=teteri66;5062976]You are correct. You do need some help. I am curious why your orthopedic doctor referred you to a neurosurgeon. Was he not an orthopedic spine surgeon? Orthopedic spine surgeons receive almost identical training as neurosurgeons when it comes to the spine. Sometimes they take a slightly different approach to the same problem and it is always helpful to get an opinion for each when one is contemplating surgery.

Regardless you do need to see a spine specialist/spine surgeon because you have some issues that need to be addressed.

The feeling of a strained hamstring is often the only sign a person gets when a lower lumbar disc is herniating. That was the case with my husband.

I will try to go through your MRI and point out the "highlights," trying to explain the terminology so when you see the spine specialist, you will be able to converse with him or her.

First, the good news: the lower thoracic area looks good and there do not appear to be problems and the first two lumbar areas, L1-L2 and L2-L3.

At the next level, L3-L4 and again at L5-S1, the discs are extruding. When a disc bulges and goes beyond its disc space, and when some of the disc material breaks through the disc wall, it is considered extruding. The disc material has broken through the annular wall, which is the outer layer of the disc, but it is still attached. If it were to break free, it would be a disc sequestration.

This disc material is pushing out into the central canal and causing moderate compression. Also, in the associated foramen, there is also what should be open space that is being blocked by this extruding disc material. The foramen are openings through which the spinal nerves pass from the spine out into the body. These are the two main areas where nerves can become compressed. it is this compression that results in the radiating pain we feel that goes into our legs and feet or upper limbs if it is a cervical problem.

At L5-S1 the same thing is going on but the extrusion seems to be affecting the left foraminal opening more than the central canal...but it is causing stenosis in both areas. This material is noticeably pushing into both the S1 and L5 nerve roots. This is probably where the worst of your pain is coming from.

If you enjoy doing a little research, look online for a "dermatome map." This will give you an idea of which spinal nerves innervate which area of the body.

When a nerve is compressed, pain can be felt at the point of compression in the spine, or it can cause pain at any point along the pathway of the nerve. My stenosis caused horrid leg pain and numb feet, but I hardly had any back pain.

So basically the discs from L3 to S1 are showing signs of degenerative change, which is causing stenosis in the central canal and some of the foramen. At L5-S1 we know for sure that the spinal nerves are being "squished" as it is apparent on the imaging. Chances are, that the disc extrusion at L3-L4 is also causing issues that are contributing to your pain.

I would imagine the spine doctor will want to try conservative treatments first, such as a course of physical therapy, oral medications and a series of epidural steroid injections (ESI) to try to shrink up the disc extrusion and inflammation.

Your mother's experiences with surgery point to the necessity of finding the very best spine surgeon that is available to you...and if surgery is ever recommended, take the time to get several opinions.

One side note: anyone that has lower lumbar problems needs to be aware of the symptoms of "cauda equina syndrome." These include sudden loss of muscle, such as a drop foot that comes on suddenly, and the loss of bladder and/or bowel control. If any of this happens to you, call your doctor ASAP or go to the emergency room. Cauda equina issues are just about the only true medical emergency when it comes to the lumbar spine. The compressed nerve must be decompressed quickly or the risk of permanent damage is high. This does not happen often, but all of us with lower lumbar problems need to be aware of the symptoms just in case....

Good luck. Please let us know how you progress and what you learn when you do get in to see the specialist.[/QUOTE]

The original ortopedic doctor I went to was a sports doc, more just bone surgery, wrist etc, he has no specialization in spine. Although he did refer me to an orthopedic spine surgeon. I'll see this guy after I see the neurosurgeon.

AndreaS84

Update time!
I found out I was pregers shortly after going to neurosurgeon.
I went through with a single level micro d last thur December 20th
They kept me over night I was up and moving like Frankenstein a few hours later. Although I only got up to pee!
The next afternoon I went home and rested. The next day and so far since I've had great daily improvement. I walked the block twice two days ago... And was soooo exhausted. I am now today not taking ANY hydrocodone or muscle relaxers!
Just a few muscle twitches here and there and sharp one second pain in left leg if I move a certain way. I've got a walk scheduled with my BF in thirt minutes and my baby is alive and kicking!
I'll update again at the end of four weeks. Hardest part is taking it easy

noevr

hi congrats on the baby! I just wanted to add that the most important thing now is to take it easy. Even though you will feel better you must not do any lifting, twisting, bending, etc. until the dr says so. This is how people end up with failed back surgery syndrome and scar tissue. So PLEASE take it easy no matter what. Cathy