[Vdub]

#29881

My history first L5/S1 fusion 2008 from a fall causing a ruptured disc. Always had pain, I was an EMT/ Firefighter sucked it up.

April 2012 came and I couldn’t get out of my car at work. Seen a different spine dr I never fused, the polymer rods and screws all broke. Revision done.

Still had terrible pain. Entered pain management. Lots of epidurals, burning of the nerves you name it nothing helped.

2014 I noticed on my MRI report about the golf sized Tarlov Cysts I had on S2/S3. Traveled to Dallas, TX from NW Indiana had them drained and wrapped. The only Dr I could find who believed they caused pain.Still had my original pain, but the feeling of sitting on a pointed rock was gone and feeling like I had been kicked in my groin by a mule was gone.

My pain has always been lower back,into my hips, into both legs to my feet. It is lightening bolt pain down my legs but the left side is worse I’d say 30% Right leg, 70% left leg, my feet are numb and tingle I can’t feel touch. The pain in my back is like I’d been hit with a bat across my lower back, think of flu symptoms the aches and times that by 1,000. Also my middle back hurts, hurt so bad it’s hard to breathe at times. My pain is always at a 5 with medication and then I have my OMG days where I just cry and hurt so so very much, I would say I have those days at least 2 times every week. Also, my left leg will just STOP working! Im telling it to walk but it is like a zombie leg (that is what I call itI never know when that is going to happen, no warning signs) so I use a can to help me with balance and walking. That is another thing, I fall A LOT!! Im always covered in bruises. Sometimes even my vision is fuzzy like the old TV’s where the channel didn’t come in clear. Sometimes double vision and my memory is horrible. I had an eye exam, all good besides I need readers, ugh. Today I was making a grocery list for my husband I could not think of the name of cheese I wanted. I knew it was yellow, and that was all. I had to explain it to my daughter and she said “Cheddar?” YES that’s it!! It happens a lot with all kinds of things. Handrailing, seat belt, remote for the TV, anything and everything. I had a head CT and they say all is good. Oh, I have an implantable spinal cord stimulator as well (2016) I can’t have any MRI’s. It helps when my pain levels are at the 5/6 but anything above that its worthless. I also have Spasticity, Hyper reflexes, migraines. I do not sleep well due to the pain. Its 6am and I haven’t slept yet. My pain in my mid back is horrific right now.

I live in a rural area and I was traveling north for P.M. they were only interested in giving me Fentanyl (which I detoxed myself off of because it was no longer effective and my PM Dr wouldn’t try Nuycenta while I was on Fentanyl but he also wouldn’t take me off it I was on fentanyl for almost2 years, the first year it worked amazing the only thing that had ever helped) and oxycontin and any other med along with countless epidurals.He never tried that medication.

So I decide to go south. They did an EMG and I found out I have permanent nerve damage at L4, L5, S1. Then a mylogram.

Findings were
T2/T3- 2mm. Spur left of central minimally indenting the thecal sac.
T6/T7- very small right paracentral spur mildly flattening the thecal sac.
T10/T11- Left paracentral disc osteophyte mildly indenting thecal sac.

Neither my PM Dr nor the neurologist who ordered the test commented on it. Why is this? Could this not be causing my mid back pain that feels like a knife is in there?

The new PM Dr had me do 4 days of Ketamine Infusions 4 hours a day. I did experience some pain relief and my husband touched my feet and I could actually feel it. But it was short lived, 2 days. The ketamine made me feel like I was in these cubes trying to get out backwards. It was so severe it took months for me not to wake in the middle of the night scared to death because I thought I was in the cubes. They give you Versed or Valium but I never slept. The ppl around me did. But I’ve been on so much medication my tolerance is very high. My husband at my last PM Dr visit asked him to do another round of these infusions. I’m scared. I don’t want to, but my husband wants me to. I understand he is beyond exhausted with my pain and limitations. I can not walk long,sit long, stand long.

Oh yes, I have also developed uncontrolled jerking movements of my entire body. My daughter was sleeping with me and she got scared and ran to her room because she said I was making a very loud growling noise and my face was contorting along with my legs “jumping” up. It’s my entire body, face, neck, shoulders, arms, hands, legs etc. I also have incontinence from time to time, bowl movements and I can’t hold urine in or sometimes I can’t get urine out.I seen a neurologist at Rush University in Chicago, IL she had 11 viles of blood taken from me. She said I was a very complicated case. It was no longer feasible for my husband to miss work to drive me the 70 miles to Rush so I stopped going. I then seen another neurologist closer to home he did EMG, EEG you name it he did it. He too said I was a complicated case but offered nothing to me.

I also have Major Depression Disorder, Anxiety, PTSD, to go along with everything else. Yay me!! I also had a hysterectomy in Dec. 2017.

I was a productive member of society I helped save lives, I fought fire, I was the only female on my crew, so I had to prove myself above and beyond what a Male would have. I loved my job. But I found myself counting seconds for my shift to be over so I could drive myself to the ER on the way home. Sadly 2014 June was my retirement.

Best positions for relief are, laying down on my adjustable bed on zero G with heat or ice, pushing a shopping cart hunched over it or oddly enough walking down hill.

Could any of the above be the cause of my middle back pain? I know females do not show the classic signs of cardiac arrest and one of the symptoms is mid back pain. But this has been going on for months.

Please any answers you may be able to give me would be so appreciated. Or tell me how to talk to my dr whether it be PM or neurology. I’m always afraid of being a baby, I don’t want to be a bother. So I let things go. Who knows maybe if I spoke up in 2008 and beyond I wouldn’t have as many issues today. Or maybe I need to see a different Dr in a different specialty?
Thank You for your time. I’m so sorry this was so long, I was trying to be as through as possible. I hope it makes sense.
Veronica

[Donald Corenman, MD, DC]

#29884

First, we have to go back to your lumbar spine images and where you are now. Did the fusion revision work and do you now have a solid fusion? Is there still compression that was missed or is there new different level pathology? What specifically did the EMG/NCV demonstrate? What does your physical examination look like? How does the area of Tarlov cysts look like? Is there nerve scar present or arachnoiditis?

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Vdub]

#29890

Yes, I do now have a solid fusion and all the hardware is intact. I do have a bulged disc at L4 but the dr says it isn’t serious. I think it looks bad, but I’m no dr. It is very obvious, even for the untrained eye to spot.

The mylogram showed no impingement of any nerve roots. I do have epidural fibrosis.

Ok, the EMG says SUMMARY: Chronic changes throughout
Lumbar paraspinals. IMPRESSION: Chronic multilevel lumbar radiculopathy.
SUMMARY: Delays in bilateral median motor nerves. IMPRESSION:Mild bilateral CTS, pt. To return for EMG Study.
SUMMARY: No response in left peroneal sensory nerve. Mild loss of axons in sural sensory nerves bilaterally.
Loss of axons in bilateral peroneal motor nerves with slowing on the left.
Loss of axons in right tibial motor nerve with slowing.
Slowing in left tibial motor nerve.
No responses in bilateral peroneal F-waves.
SUMMARY: No response in left peroneal nerve. IMPRESSION: Transmission deficit in left peroneal system.
There are graphs and numbers throughout these reports that I do not understand. Wish I could take a picture and post it. But I do not see an option for that anywhere. Also, I don’t understand what I typed out above either.
Also another page has an excel like worksheet that on the top has IA, FIB, PSW, FASC, H.F. and above those it says SPONTANEOUS. AMP, DUR, PPP, have above that MUAP. Pattern and above that says RECRUITMENT. Then on the left side of the paper lists L.VAST MEDIALIS and in all the boxes listed above says either N or NONE. L.LUMB PSP (U) has N or none listed in everything except PPP is 2+ and Pattern is listed as REDUCED. R. LUMB PSP (U) same listings as above. L.LUMB PSP (M) same listings as above. R LUMB PSP (M) listings same as above. L. LUMB PSP (L) listings same as above. R. LUMB PSP (L) same listings as above. The rest of the things are N or NONE.

Physical examination? Not sure what you mean? I am overweight, 5’6″ 200 pounds, I don’t look that heavy I am proportioned. No other health issues. I can not walk on my heels or toes. I can’t resist the dr when he moves my feet. My hamstrings are extremely tight. Range of motion is somewhat compromised. Hard to twist without pain.

I do not know how the area of Tarlov Cysts look, no one has ever noted anything on CT, mylogram, Xray,MRI etc.

Anything else I left out? Thank You so much for your time.
Veronica

[Donald Corenman, MD, DC]

#29915

Did the report come to some conclusions? Not findings such as positive sharp waves (this is a finding and not a conclusion) but what the cause of multiple delays in conduction could mean. The conclusion could be peripheral neuropathy, compressive neuropathy, chronic radiculopathy or any of those specific type of findings.

Physical examination findings could be anything from sensory decrease in a specific dermatome, reflex changes, motor weakness, range of motion and nerve tension findings.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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