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  • Who's lying Neurosurgeon or Radiologists?

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    Old 07-08-2011, 12:13 PM   #1
    Kristy1974
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    Angry Who's lying Neurosurgeon or Radiologists?

    History: My mother is a Nurse Practitioner in interventional radiology and works with three Radiologists. I called her with my symptoms of neck and back pain (like a horrible crick down right of spine) that wouldn't go away. I had right shoulder pain, headaches, right arm numbness and tingling and later that numbness went to my face and neck (rt side) as well. I was informed it could be something important and I should go to my Dr. and have an MRI ordered. The Dr. saw me and agreed. He also gave me two injections in the neck while I was there. Not sure what they were but I recognized the name of a steroid in the mix as he ordered the nurse to bring it. The MRI was performed at the hospital and the radiologist interpreted it as : The vertebral bodies are normal in height with REVERSAL NORMAL CURVATURE centered at C5-C6 level. The marrow signal of the vertebra is within normal limits. The disc heights are well-preserved. C5-C6: There is a disc osteophyte complex worse in the left paramedian position with mild left central canal stenosis. After review of the MRI I sent a copy to my mother and the 3 docs she works with. They all agreed...NOT GOOD that I needed a neurologist. Once my family Dr. got the results, he and his Nurse practitioner said there was no need to see an orthopedic Dr. and referred me striaght to a neurosurgeon. My appointment was yesterday. He did a physical exam of my reflexes/strength and questioned me about my symptoms. I told him that after the shots I still have the symptoms, but they are less and they seem to relocate from one place to another as opposed to all areas like before. He looked at me like I was crazy and said let me look at the MRI again. He came back and said there was no logical explaination for my symptoms that all he noticed was some arthritic changes that he would expect to see in someone of my age (36). I asked if it could be the nerves causing it...he said there was no nerve compression. I asked about kyposis and he said there is some but it is nothing that would cause symptoms. I asked if it could be muscle related and he said he could not say what would cause it but that it is not spine, nerves or spinal chord isues and he could not help other than order a nerve test and then proceeded to tell me how painful and expensive they were and usually didn't show anything that he would not have noticed on physical exam anyway and well...i could tell he was trying real hard to talk me out of it like I was wasting his time. I was so humilliated. He made me feel like he thought I was making everything up. Thing that really got me is that the 4 Radiologists 2 nurse practitioners and 1 MD that saw the results agreed and he pretty much told me they were liars. Correct me if I am worng, but isn't central canal stenosis compression of the spinal chord? and if your spinal chord is compressed isn't it logical to think the nerves would be as well since they surround the spinal chord? And since the kyphosis was first noticed 7 years ago by a rheumetologist and has progressively gotten worse to the point of causing stenosis and radicular pain, shouldn't some kind of preventative action be taken to keep it from getting worse? Why would a doctor do that? Maybe it is because I have been diagnosed with fibromyalgia and he thinks it is a "cry baby" diagnosis. Let me tell you I have been to the hospital 6 times in my life - 2 children, 1 LEEP for cancerous cells, 1 total hysterectomy for endometriosis, 1 removal of a gallbladder that was full of stones, rotten and causing elevated enzymes in liver before I ever even hurt bad enough to go to hospital, and 1 time to have the tip of my index finger sewn back on because I cut it off in the house door and even then the pain was not severe...so I don't just go to Dr. for no reason. Maybe it is not as serious as all the others were saying or maybe it is to risky for him to want to deal with? I left his office doing everything I could not to cry until I got in my car. I did not want to be hurt, I did not want to need surgery, I was already scared to death and then I was humiliated by some jerk doctor. What ever happened to bedside manners? I was wearing over $20,000 of diamonds, carryinhg a $350 purse, have wonderful insurance and my husband owns a finance company - but he acted like I was some street person who couldn't pay for another test and told me I probably needed to go home and think about it before committing to the expense. WHAT?!?!Sorry to rant I am just upset and lost now, cause I am no better off than before. Can anyone give me their impression of what was going on with the two totally different opinions?

    Last edited by Kristy1974; 07-08-2011 at 12:34 PM. Reason: typos

     
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    Old 07-09-2011, 09:07 PM   #2
    SpineAZ
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    Re: Who's lying Neurosurgeon or Radiologists?

    Perhaps a consultation with another doctor, maybe an Orthopedic Spine Surgeon since you've already seen an NS. I personally have had better luck with OSS for my cervical and lumbar surgeries, but also consulted with a great NS.

    It's not uncommon for three NS to have differing opinions. You know your body best, so seeing additional physicians may help you. My prior OSS did not think my low back issue was anything to worry about, my new OSS did a simple x-ray with me bending over and saw my vertebrae (L3) was slipping forward. Because he listened to me he logically went through the options of testing, did x-ray and MRI, and ended up doing surgery which helped a great deal
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    Last edited by SpineAZ; 07-09-2011 at 09:10 PM.

     
    Old 07-10-2011, 12:21 PM   #3
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    Re: Who's lying Neurosurgeon or Radiologists?

    Kristy

    "but isn't central canal stenosis compression of the spinal chord?"

    Not necessarily. The canal should be somewhat wider than the cord. If the cord is, say, 10mm, then the canal might be 18mm. The remaining space in the canal will be filled with fluid, which will show as white on an MRI.

    If you have canal stenosis for one reason or another, then your likelihood of compression is increased, simply because the cord has less leeway. However, if the radiologist says the stenosis is "mild", and doesn't mention cord compression at all, then he's saying the stenosis is not, at present, a problem. Besides, symptoms on your right side would not be caused by stenosis on the left side.

    While a C5 problem could affect your arms, symptoms in the face would originate much higher.

    So I'm as much confused as you seem to be. I wish you the best in getting to the bottom of it.

    p.s. Neurosurgeons make the big bucks by operating. So if the n/s is the one guy who doesn't think you need an operation, he may be wrong, but I doubt that he's trying to mislead you.

    Last edited by WebDozer; 07-10-2011 at 12:24 PM.

     
    Old 07-10-2011, 07:05 PM   #4
    jennybyc
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    Re: Who's lying Neurosurgeon or Radiologists?

    I second what Webdozer is saying. And I suspect the shots the doc did were trigger point injections on the side of your spine. If that helped even the slightest, then a lot of your pain may be from the muscles. I've had those same shots. The spine may be causing some nerve inflammation and then the muscles go to work trying to protect the spine and they get tired and spasm. The muscle issues with an arthritic spine can cause more pain than anything else.

    In your MRI, it talks about canal stenosis...that simply means the canal is smaller than it should be. If the stenosis was compressing the "thecal sac" when it would be pressing on the enclosed fluid sac around your spinal cord. If it was actually compressing the cord, it would say as much by the use of terms like minimal, mild, moderate or severe compression and then give the width of the cord at the compression points. None of that is recorded.

    Believe it or not, you can have your spinal cord compressed down to half thickness with few symptoms. I know...I had it at 4 levels in my neck.

    Similarly, if you had compression of the spinal nerves that peel off at each level and exit out to the body, you would see terms related to the "foramina"(the holes in the vertebrae for the nerves to exit) and they rate the amount of compression with the terms minimal, mild, moderate and severe. None of that is there.

    Straightening and/or reversal of the lordotic curve is normal as you age. And it's only at C5-6, not the entire neck so that is good.

    But you definitely have arthritis and that hurts. Bone spurs rub and cause pain with movement. That pain can trigger the muscle spasms and you have a vicious cycle that never ends until you are in so much pain you cry.

    I've had 2 major neck surgeries and I interpret a lot of the MRI's here for people(good at doc speak) and your neck is not bad at all. But unless you've seen a really bad MRI, any MRI of the neck can look bad. And they will always tell you to see a spine surgeon.

    BTW, most neurologists don't deal with spine issues. And when you see a neurosurgeon, it should be a spine neurosurgeon, not a general neurosurgeon. You want one who does nothing but spines. Or you could see a spine orthopedic surgeon...they do necks too.

    But nowadays, most docs will send you to a pain management doc to help you control all the pain until you do have something surgical they can fix. Your rheumy might help you with that too. Mine did.

    No one should ever rush into any kind of neck surgery. Spine surgery for pain relief only has a 30% success rate and a 1-3% rate for paralysis after surgery. When you get to the point of developing numbness and muscle dysfunction, then it's time to get surgical intervention.

    I truly think your mom and the docs she showed your MRI to were the ones who were wrong. And any MRI has to be coordinated with the symptoms you have. It can look bad but if the nerve dysfunction isn't there, then it's not surgical. They don't operate for pain with the spine, they operate to try to stop you from becoming paralyzed.

    Hope this helps. I've had to learn it the hard way.

    Jenny

     
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    Kristy1974 (07-11-2011),SpineAZ (07-11-2011)
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