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  • jewelz
    Member
    Post count: 4

    I have been in increased low back, hip and abdominal pain in the last 6+ months.
    Then my bladder suddenly stopped working in Sept. So I have a catheter in since then. Also bowel problems progressively worsening since became unable to urinate, now unable to make bowel movements for past week or so.
    My specialist ordered MRI of lumbar with contrast, and I am very concerned about a finding on there:
    It says 3.8 mm enhancing nodule along the roots of cauda equina at lower L4 level. Only seen on postcontrast images. May represent small neurogenic tumor such as Schwannoma/neurofibroma – Drop metastasis is not excluded.
    I got MRI the results online, and do not have appt. with my dr. to discuss them until next week. So I am unable to ask him about this currently, and I am extremely worried about cancer or other (I have been increasing ill and lost 40 pounds unintentionally in past 6 months also, along with fevers, night sweats, increased severe fatigue – Sleep 20 hours at a time some days/nights.
    Can you give me advice if this sounds like cancerous or any idea what it may be? Also if that could be causing my bladder to stop working and bowel problems?
    Any info/suggestions on what this nodule on caudal spine could possibly be would be very appreciative, as I am so worried. Thank you so much.
    Julie

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Bowel and bladder dysfunction is generally a central nervous system problem although a very large disc herniation in the lumbar spine (cauda equina syndrome-see website) can also cause this.

    There is no evidence of significant nerve compression in your lumbar spine to contribute to your bowel and bladder dysfunction. The small enhancing nodule may be nothing (neurofibroma- a small generally benign tumor) but can be from something more problematic.

    A “drop metastasis” is a neoplastic tumor from higher up in the cord or even brain that has shed cells. These cells then “drop” down in the CSF due to gravity and attach lower in the dural sac.

    Significant unintentional weight loss is a sign that much more work-up needs to be completed to discover what the cause of this weight loss is from.

    A brain MRI is warranted as well as possibly MRIs of the cervical and thoracic spine.

    Dr. Corenman

    jewelz
    Member
    Post count: 4

    Thank you so much for your quick and informative response.

    I just have a couple additional questions regarding that –

    Could a central nervous system problem from my Chiari Malformation possibly cause the bladder & bowels to stop working if it worsened?
    (My last cervical MRI w/out contrast showed the chiari herniation worsened a year ago – from prior year). I have not been to surgeon for that yet as my health has declined too much to make the trip.

    Then I fell down very hard just before my bladder stopped working and all my chiari-type neurological problems – headaches, pressure, dizzyness, vision spots/flashing lights, blurring, autonomic dysfunction, vagus nerve dysfunction, etc all got worse – the same time my bladder stopped working. (So possibly the jar from the fall worsened it again more).

    But since my low back & hip pain also has been severely increasing since I fell, I was thinking it was all due to lumbar.

    So I am just wondering if the Chiari Malformation is something that could cause the bladder/bowel dysfunction?

    And also if that small nodule/tumor (which I will take your advice and ask my doctor for further testing, including brain MRI) on Cauda Spine could possibly cause such increased pain through low back and hip (even though it is so small) since nothing else is showing in lumbar area to cause all that increased pain? Or do you think that is too small to cause any pain?

    Thank you so much for your time and all your helpful advice,
    I really appreciate it!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Chiari malformation (compression of the spinal cord at the base of the skull) can cause your bowel and bladder symptoms. A fall can aggregate this condition and cause further dysfunction of the cord.

    An MRI of the brain should include the cervical spine as these Chiari malformations can be associated with a syringomyelia (a swelling of the middle of the spinal cord).

    You need to get into a base of skull specialist to have a full workup. Do not hesitate on this.

    Dr. Corenman

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