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  • Tumors on Spine... What?

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    Old 11-20-2013, 06:08 AM   #1
    WhistleDixie
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    Tumors on Spine... What?

    Hello All...Can you help me crack the code of my MRI results? It reads as follows:

    Decrease in bone density.

    There is slight straightening of the normal anterior curvature.

    Narrowing of the C5-6 disc space. Minor forward slippage of C7 on T1 by 1 to 2 mm

    There is levoscoliosis with the apex at the L2-3 disc space.

    At L5-S1 there is tiny central and right-sided disc protrusion w/evidence of contiguous annular tear. It abuts the right S1 nerve root but does not result in nerve root displacement.

    At L4-5 there is minimal disc bulge with marginal osteophyte lateralizing into the left neuroforamen. There is mild left sided neuroforaminal encroachment. The disc osteophyte complex abuts the left L4 nerve root without significant impingement. There are some discogenic end plate changes that are preferentially left sided.

    There are scattered vertebral hemangiomas but no neoplastic marrow replacement is evident. (I have a history of stage 4 endometriosis. Could these blood tumors possibly be endometrial lesions on my spine?)

    My orthopedic surgeon ordered this MRI after my recent Synvisc injections for bone on bone pain in both knees. I saw her yesterday for follow-up. She insists that I see a neurosurgeon next Tuesday. I've been told by numerous neurosurgeons in the past that surgery "would not fix my spine issues" of stenosis, DDD and osteoarthritis. While I know that knee replacement is on the horizon for me, I simply cannot emotionally survive more surgery at this point...if ever=(

    ANY thoughts will be appreciated, as I am freaking out about all of this. Thanks.

     
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    Old 11-20-2013, 06:32 AM   #2
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    Re: Tumors on Spine...What?

    I would suggest you see a fellowship-trained orthopedic spine surgeon since you have seen neurosurgeons in the past. Their post graduate training is similar to that of the neurosurgeon but they sometimes approach a problem from a slightly different point of view. (remember that orthopedic surgeons specialize now -- you want a spine ortho whose practice is limited to the neck and back.)

    To my layman's eyes, nothing about the MRI demands that you see a spine specialist immediately. Hemangiomas are usually not a cause of concern -- but given your history I would want to have it checked out just to be sure.

    Do you have left-sided pain, perhaps sciatic pain?

     
    Old 11-20-2013, 06:44 AM   #3
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    Re: Tumors on Spine...What?

    Thank you for your response. Yes, I have intense sciatic pain radiating into my left hip and leg. My orthopedic surgeon says that's a contributor to my left knee pain, in addition to severe osteoarthritis (resulting from Lupron and surgically induced menopause @ 32, with no possibility of HRT and absorption issues with Vit D and Calcium)

    I asked her to explain the need for neuro consult, to which she bluntly replied SHE has done ALL she can do for me until I consent to knee replacement. Meanwhile she sees "significant causes for concern" to be evaluated by a neuro asap. She has referred me to a spine clinic, and insists I see him on Tuesday.

     
    Old 11-20-2013, 07:43 AM   #4
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    Re: Tumors on Spine... What?

    [QUOTE]ANY thoughts will be appreciated, as I am freaking out about all of this. Thanks.[/QUOTE]

    [B]PLEASE HELP ME! I know there are many of you on these boards with a wealth of knowledge to share.[/B]

     
    Old 11-20-2013, 07:48 AM   #5
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    Re: Tumors on Spine... What?

    While it is definitely true that issues in one joint definitely influence what goes on in other joints, other than making sure the hemangiomas are not a significant finding, I do not see anything that is a big cause of concern.

    [B]At L4-5 there is minimal disc bulge with marginal osteophyte lateralizing into the left neuroforamen. There is mild left sided neuroforaminal encroachment. The disc osteophyte complex abuts the left L4 nerve root without significant impingement. There are some discogenic end plate changes that are preferentially left sided.[/B]

    Yes, there are degenerative issues indicative of spinal arthritis. For example, there are osteophytes, which are little bony "spurs" that typically begin to grow as the discs begin to degenerate. This is moving into the left foramina, occupying space that is otherwise needed by the nerves to function normally. However, the report indicates "mild."

    In the world of spinal radiology, the four words that are used as a classification system are as follows: minimal, mild, moderate and severe. I realize that when one is in pain, it doesn't matter whether the condition is thought to be mild or moderate, but, in terms of the doctor's concerns, mild is worth watching but does not demand any specific action.

    If the hemangiomas are not a significant finding, I should think the spine surgeon would review your films, and explain what you said in your first post: that you have some DDD, some mild foraminal stenosis and some arthritis in your spine, and that while it is painful, not much can be done other than some pain management. The concern would be nerve compression, but at least the MRI report indicates this is not a problem. It may become one in the future, but for now, the nerves are not being compromised.

    The report is just that....one doctor's interpretation of what he/she sees on the MRI. Perhaps your doctor sees something on the films that is a cause for concern that wasn't picked up/reported by the radiologist.

     
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    Old 11-20-2013, 08:01 AM   #6
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    Re: Tumors on Spine... What?

    Again, thank you "T" for your time and input. I just don't see the need for ANOTHER 2 hour drive to spend the day seeing ANOTHER specialist, who will quite likely refer me to yet ANOTHER specialist. Since early August I have seen a urologist, a gastroenterologist, 2 gynecologists specializing in treatment of endometriosis, 1 gynecologist specializing in treatment of pelvic pain, and my orthopedic surgeon 3 times. I've had thousands of dollars worth of tests, immeasurable stress waiting for results, and not 2 cents worth of solutions. I have no glimmer of relief from multiple health issues and quite frankly, no hope.

    Last edited by WhistleDixie; 11-20-2013 at 08:02 AM.

     
    Old 11-20-2013, 04:53 PM   #7
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    Re: Tumors on Spine... What?

    You may not see the need, but you don't seem to have the answers you are looking for, so what are your options?

    I assume your orthopedic doctor is not a spine only ortho. If that is the case, then you haven't explored all your options. I'm not sure what it is you are looking for. Your doctor apparently recommends knee replacement, which I assume you are not rushing into. You have sciatic pain, but apparently have not been given satisfactory information from your visits to the various neurosurgeons you have seen previously, and do not have a satisfactory plan of treatment to help you deal with the pain.

    Do you think your internal problems and spinal issues are linked? Perhaps it would be beneficial to go to a multi-specialty clinic like the Mayo Clinic in Jacksonville, FL where a team of doctors could do a work-up.

     
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    Old 11-25-2013, 10:06 AM   #8
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    Re: Tumors on Spine... What?

    My appointment is tomorrow...What can I expect? I don't mean to "whine" but I am scared, and that's not like me...EVER. My biggest fear is that yet again I'm going to be made to feel that "it's not possible" that I endure so much pain. I have an aversion to additional surgery, so I am viewed as difficult to treat. I have extensive gastrointestinal problems that make oral meds problematic at best...but I am WILLING to try if it's not a medication that I've already tried with horrid results.

    Yes, T...I couldn't agree more with you in that I would benefit from a comprehensive "work-up" at a hospital with MANY specialists working together to address my skeletal pain, as well as my pelvic/abdominal pain. That's why I pushed SO hard to see GYNs at UT and UMMC this summer. They sent me away in tears, telling me that it's most likely adhesions...not residual endometriosis. There is nothing they can do for me. Meanwhile my bowels become more resistant to the methods I've used for over half my life (softeners, fiber, laxatives) sometimes 7 to 9 days without BM resorting to multiple enemas. Colonoscopy in April...gastro says "looks fine" and recommends Linzess. I can't afford it, as insurance does not cover prescriptions. I lost my Donnatal as well, because no longer available in generic...can't afford $215+ monthly for one drug. It was my salvation for many years.

    Sorry for the long post...just needed somebody to listen, I guess. It's sleeting here this morning, with the same forecasted for tomorrow. I have to drive 2 hours one way to see this neurologist in CRAZY traffic, especially 2 days before Thanksgiving. My husband will not be flying in until Wednesday evening, so I have to go alone. I'm just scared because I KNOW that doctors can be jerks...making me feel even WORSE about myself than I already do.

    Thanks for listening.

     
    Old 11-25-2013, 11:43 AM   #9
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    Re: Tumors on Spine... What?

    I am sorry you are having so many problems. I read a lot about adhesions after abdominal surgery because it is much more common and therefore, there is much more written about it than about adhesions from spine surgery. Unfortunately it sounds like you are dealing with several different conditions that are probably not related.

    The only tip I can give you for your appointment tomorrow is to try to be specific in describing your pain. Don't say something like "I'm in so much pain I can't stand it." This is pretty much what spine surgeons hear all day long and they just don't pay all that much attention after awhile.

    You need to give him more detail so he has a better idea what may be causing the pain -- things like describe what activities cause it to hurt more or less. Is it constant or does it come and go? Does it switch sides? Sometimes describing how the sciatic pain or other pain impacts your daily life helps as well. Just think about all this ahead of time, maybe even jot down a few notes just in case. Most of us tend to forget the significant points in the presence of the doctor!

    I hope the weather clears up and you do not have that additional stress to deal with. Good luck, and let us know what the neurosurgeon advises.

     
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    Old 11-25-2013, 01:03 PM   #10
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    Re: Tumors on Spine... What?

    Thank you for your kind words. I agree that I need to be prepared. I've faxed my plethora of "new patient" forms and I obtained the MRI CD in addition to 2012 x-rays of cervical and lumbar.

    As stated earlier, I am not easily frightened as I have faced pain and adversity most of my life. I live by the mantra of "don't make excuses, make it happen". It is that borderline "insanity" that drives me. My threshold for pain is Mt. Everist, not because I am a sadist, but because as you said in an earlier post "what are my options?". I decided this summer to once again pursue the possibility of a doctor who would spend as much time to "help" me as I spend filling out their forms and drawing on their "pain diagrams", just to get in to see them.

    I was quickly reminded of why I gave up the pursuit of relief (forget happiness) many years ago. I try to avoid blanket generalizations, but I will say that the doctors I've dealt with just these past months are suffering from digital dementia. They won't look up from their devices to even make eye contact. They treat me as if I'm old, damaged goods and beyond help. In 1994 it took my suffering liver failure (feared cancer) to get the attention of a cancer surgeon. He rushed me to Oshners Medical Research Facility in New Orleans. Thankfully, it wasn't cancer. It was stage 4 endometriosis (duct blockage by lesion) The disease had consumed my belly organs for the many years I'd begged specialists to help me. The cancer surgeon basically had to "gut me" like a deer to clean away the disease and free my organs, removing all things female. So...my life is not easy, nor do I expect it to be. I just feel so very alone, as I share my pain with no one but my husband. He is a kind and loving man who KNOWS how I suffer in silence behind the mask. My extended family (including my 87 yr old mother and 78 yr old MIL) really don't care "how" I'm doing...as long as I get it done...(whatever that may be) for them. I've always been the "Calvary"...but right now I need a WHITE HORSE on MY horizon.

    Based on past experience, the approaching thunder of horses' hooves would be more likely my own personal apocalypse. (4 horsemen being GYN, GASTRO, ORTHO...now NEURO) I prefer death.

    Last edited by WhistleDixie; 11-25-2013 at 01:07 PM.

     
    Old 11-26-2013, 04:47 AM   #11
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    Re: Tumors on Spine... What?

    WhistleDixie... OK, I found your thread, and read your report. I think I really should say no more than that you came to the right place, and are talking to the right person - Teteri. She knows much more than I do, particularly on lumbar issues, so it's best if I just stay out of the discussion. Good luck....

    Last edited by WebDozer; 11-26-2013 at 05:01 AM.

     
    Old 11-26-2013, 08:27 AM   #12
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    Re: Tumors on Spine... What?

    Ha Ha! Please add your two cents, Webdozer!!

     
    Old 11-27-2013, 05:10 AM   #13
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    Re: Tumors on Spine... What?

    Well...I am hurting and I am frustrated. I saw the neurosurgeon on Tuesday, as planned. I drove 4 hours round trip (alone) in frigid rainy (intermittent sleet) weather. He was fairly nonchalant about everything he saw on my MRI. He said that no surgery will correct the cervical...just have to "live" with it. He said the lumbar has surgical "possibilities" but he does not recommend because more often than not "they fail". He referred me to their Department of Physical Medicine and Rehab, but I won't see them until 12/18.

    How do I continue to "live" with mind-numbing pain? I give up. I needed resolution, not "run-around" of these past months, bouncing from one specialist to the other, only to be told I have to "live" with it. I could/should have saved my energy and avoided all of this disappointment. But indeed what choice did I have? I did it. I'm done. I'm not going back. I am in such a dark place I don't know how I'll make it through this day.

    Forget about even the possibility of Thanksgiving...not happening this year. If my pain is not relieved (and there seems no possibility of that based on recent events) then I can't go on.

     
    Old 11-27-2013, 05:57 AM   #14
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    Re: Tumors on Spine... What?

    I am sorry your appointment turned out as you had expected. What did the doctor say about the hemagiomas?

     
    Old 11-27-2013, 07:07 AM   #15
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    Re: Tumors on Spine... What?

    He said "I see those so commonly, I don't even pay attention". Not much comfort, whether endometriosis related or not. That degree of apathy in the gynecological field cost me my life as a female. I've just had to "live with (or without) that", too.

    I'm sorry I'm bitter. I wasn't always this way. Thank you so much for your assistance.

     
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