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  • Tammysroses
    Member
    Post count: 5

    Dear Dr Corenman,

    Thank you for the time to help people! You are an amazing person.

    I am a 46 year old female who was working out 5 days a week, cardio weight lifting,Stop for a bout a month, So first week in July was at a wrestling camp in Nebraska sitting on a hard bench for 4 days,watching my son,remembering how much my butt and back hurt from sitting there,So I would get up and walk around..But the big problem was my right calf muscle started to contract never get a cramp, but you could see the muscle going in and out..Well on the long drive home back to the mountains in Colorado, My leg was still contracting, went to work the next few days and legs were so stiff and in pain,( I am a waitress)..So the pain in the legs got bad,Stiffness,aching,weird sensations..Went to Doctor after Doctor,One doctor had me do test for ms, brain Mri Normal EMT, normal NCS normal..All blood work normal..Started going to the chiropractor, Everytime he would work on my lower back I was buzzing like he was moving a nerve…Did that for 6 weeks didn’t work, he did say I have a fracture and maybe a pinched or irritated nerve, He said you should have seen me years ago..Thought that was funny..So after the chiropractor..Finally had a MRI done of the Lumbar All the doctors seem to think it is Ok!!!Including one of the spine doctors…

    MRI FINDINGS….
    LUmbar vertebral morphology, alignment and bone marrow appear normal.There is a T2 signal loss and narrowing involving the T11-12, L3-4 and disk spaces reflecting desiccation and degeneration.There appear to be minimal posterior protrusions at L3-4 and L4-5.A benign hemangioma lies in the vertebral body.

    The conus medullaris and cauda equina appear normal..The conus terminates at L1

    There is a unilateral pars intraarticular defect on the right aspect of L5 without associated spondylolisthesis.

    The T12-L1 L1-2 L2-3 and L5-S1 disk levels are normal.

    L3-4 theere is very minimal broad based protrusion measuring less than 3mm Grade 1..It does not produce significant canal or foraminal narrowing.The facets are mildly degenerated.
    L4-5 there is a very minimal right lateral protrusion measuring less than 3mm grade 1. It does not produce foraminal nerv root or spinal canal compromise the facets are slightly degenerated..

    IMPRESSION:
    1. Minimal grade 1 protrusions L3-4 and L4-5 without significant canal foraminal or nerve root compromise.
    @. Unilateral right L5 pars interarticularis defect.

    So after this went to pain management center, received an epidural block. Somewhere in LTF E S1… Didn’t work, Second one lumbar facet Lss. Numbing medicine work steroids did not help..Went back to confirm. numbing medicine only worked for about 45 minutes, Don;t know if I am a candidate for rhizotomy, cause they want the relief to be 2-3 hours…
    My back just stared getting worse with more pain..60/50 Legs 80/20..When sitting my back hurts and buttocks and legs hurt real bad when getting up from sitting position I am stiff..When standing legs hurt calf’s hurt throbbing pain…Thighs feel achy, buttocks hurt..Walking feels better …Pain in my ankles, some spasms in buttocks and legs..
    My question to you is..Should I get a new Mri, the pain is intolerable the pain makes me tired all the time,,What can I do!! No doctors have given me any answer..Just wondering what you thought!!

    Forgot also had an Mri Of my pelvis, No one has said anything about that!! Do you think it might be a compressed nerve, I mean the buzzing is weird…
    Thank you so much! I hope I made this so you can understand it..

    Tammy!!!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    It might be worth getting a CT scan limited to L4-S1. If there is one pars fracture at L5-S1, the MRI might under diagnose the other side. Bilateral pars fractures at L5 with micro instability could explain your symptoms. If your symptoms are only unilateral (one sided- the symptoms do not sound one sided), the pars fracture might also be a pain generator.

    Facet blocks with only 45 minutes relief do not lead me to consider a rhizotomy but you did have good relief from the first set. Like anything else in spine, there are never consistently perfect injections. Another repeat injection of the type that failed the second time might also be considered. Good relief for at least three hours would lead to potential rhizotomies.

    Dr. Corenman

    Tammysroses
    Member
    Post count: 5

    Hi Dr Corenman,
    Just got another Mri, because of all the pain I am having..The mri goes like this…

    L4-L5 Mild circumferential disk bulging is noted with ligamentum flavum and facet overgrowth.Mild bilateral neural foraminal narrowing is noted without canal stenosis.
    L3-L4 Mild circumferential disc bulging is noted without canal or neural foraminal…L2-L3 Negative L1-L2 negative T12_L1 negative..

    So my question too you is< can this be causing all the pain in my legs? this Mri Did not pick up on my Pars fracture at L5….my buttocks, upper thighs, calfs ankles to my feet, are always in pain, numbness, tingling, buzzing here and there…But leg pain is awful…Compared to my other Mri, it never mentioned facet overgrowth and what is that, not getting much help on finding the definition on that.Just wondering what you thought..

    Thank you for getting back to me, on the first Mri, Tammy

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Pars fractures are not easy to diagnose on an MRI and you can now see the dilemma that occurs when depending upon a radiologist’s report. The findings of your second MRI might suggest a degenerative spondylolisthesis at L4-5 but that may be over-deduction.

    Again, you might consider a limited CT scan of L4-S1 to help differentiate these disparate image readings.

    Dr. Corenman

    Tammysroses
    Member
    Post count: 5

    Thank You Doctor,
    Was pushing for the CT scan, but she said an Mri is better..I will keep trying… Thank you so much!!!

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