[SpasticSpine!]

#5052

I have 20% scoliosis with no progression, fracture to T12, spondylolisthesis Grade 1/2 and spinal stenosis. I don’t have much of back pains unless I squat to do weeding. I have pain in my left lower buttocks, which goes down to outer left thigh and left thigh. and the part between thigh and pelvic bone. This only occurs when I walk or stand for too long and once I sit down it is ok. By the way, I used to have pain that goes down the left leg and turns to pins and needles and numbness but this part stopped when I changed jobs and no longer to physical shifting of filing compactuses. Just 4 months ago, I started to have a slight urinary leakage. All my life I have always had frequency and urgency to go. Would the recently leakage by any change be caused by the nerve compression from the stenosis? I am 48 years of age. I have just been referred to a Continence Physiotherapist and I have been advised maybe later to a Gyno.

Any advise appreciated.

[Donald Corenman, MD, DC]

#5054

Let’s start from the beginning. I assume you have a scoliosis of 20 degrees that has not progressed in the last 5 years. I will assume it is in the thoracic spine with a small compensatory curve in the lumbar spine. You have a fracture of T12 but do not mention how severe. Does the fracture cause kyphosis (see fracture section on website)? If so, how much kyphosis is present?

You have a spondylolisthesis in the lumbar spine- grade 1-2 with spinal stenosis. I will assume it is a degenerative spondylolisthesis and also assume it is at L4-5 as this is the most common level to develop a slip (see website). Isthmic spondylolysthesis is not normally associated with spinal stenosis.

The leg pain associated with standing and walking is quite common with the disorder degenerative spondylolisthesis/ spinal stenosis (see website). The spinal canal becomes narrower with standing and walking and enlarges with sitting and bending forward. The buttocks pain occurs from nerve compression with standing and goes away with sitting.

Spinal stenosis can cause compression to the small filamentous nerves that travel in the spinal canal and innervate the bladder but this condition is very rare. It is called cauda equina syndrome and there are many other symptoms that you do not complain of that go with that diagnosis (see website).

One of the most common problems leading to urine leakage is a stretched pelvic diaphragm. Women who have had children are prone to this disorder. A trip to the urologist or GYN might be valuable.

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.

[SpasticSpine!]

#5062

Thanks very much Dr, that really puts my mind at ease re cauda equina which was my concern.

No kyphosis, no children, yes L4/L5 and no progression to scoliosis since 1984. My pains are bearable as long as I can find somewhere to sit. I just want to take the opportunity to mention that the first specialist I saw recommended that I should have fusion abut the 2nd opinion I went for did not recommend surgery. So what I am saying to those reading is sometimes it is helpful to get another opinion and yes I agree, any online forums suggestions/advise are to open our eyes and options and not to be taken as formal medical advise.

Thanks again, muchly appreciated.

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