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  • Avatarbedunm43
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    Post count: 1

    RADIOGRAPHIC EVALUATION: X-rays of the lumbar spine obtained today do show a bit of a curve at the thoracolumbar junction, nothing significant. No lateral listhesis is noted. Lateral view shows early degenerative disc at L5-S1. No listhesis is noted. There is an MRI available for review dated 02/03/20 that shows pretty well hydrated discs from L4 above, the L5-S1 disc is a bit degenerative. Axial images show maybe a little bit of thickened ligament at L4-5 which potentially causes lateral recess stenosis. Really no high grade stenosis either centrally, foraminally, or in the lateral recess is made note of. Degenerative disc at L5-S1 without stenosis.

    IMPRESSION:
    Most likely symptomatic left lateral recess stenosis with radiating left leg pain.
    Early degenerative disc at L5-S1 with mild back discomfort.

    PLAN: I had a lengthy discussion with the patient regarding the problem and treatment alternatives. We did review the x-rays and MRI with her as well as the pathoanatomy and pathophysiology of the problem. We went over her options for treatment. Dr would recommend trying a left L5 selective nerve root block with local anesthetic only. If this eliminates her left leg pain, then I think she would be a candidate for a decompressive procedure at L4-5. If it does not help her leg pain, then Dr. would recommend that she try to manage this conservatively as this would suggest it is not coming from the lateral recess. She voiced understanding and is in agreement. We will get her set back up with Dr. and she will let us know how she does after the injection. We will make a plan from there. The patient was seen in conjunction with Dr. who did meet with the patient today.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7982

    This does not describe your personal symptoms in your own words but I do like the path this physician is taking with the diagnostic blocks.

    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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