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#6642 In reply to: Surgery fusion |
Dr Corenman,
I am a 60 year old female.The surgeons want to do my neck first as they are fearful of my becoming paralyzed even from a fall. Please see the following:
MRI:date 3/30/12
Cervical: w/o & w/contrast:
1. spondylosis C3-4 through C6-7 with moderate to marked bilateral foraminal narrowing, moderate to marked C4-5 canal stenosis, moderate C5-6 canal stenosis and mild C3-4 and C6-7 canal stenosis. there is mild cord compression at C4-5.
2. advanced C3-4 through C6-7 DDD
3. mild thoracic dextroscoliosis with straightening of the cervical lordosis.Cervical xrays:
1. far advanced C3-4 through C6-7 DDD
2. prominant bilateral sponylosis at the same four levels with associated foraminal encroachment.Thoracic: without contrast:
1. moderately advanced ddd in the mid and lower thoracic spine.
2. small central disc protrusions at the three lower thoracic levels with mild thecal sac compression with mild disc bulging at three mid thoracic levels.
3. mild dextroscoliosisLumbar: w/o & with/contrast:
1. far advanced chronic DDD L1-2 associated with chronic loss of stature of the L1 vertebral body
2. moderately severe L1-2 canal stenosis with prominent bilateral foraminal narrowing secondary to sponylosis, disc bulging and facet hypertrophy.
3. status-post fusion L2-S1, decompressive laminectomy L3-4 to L5-S1, and intervertebral body fusion L4-5 with a stable mild anterolisthesis.
4. moderate levoscolosisLumbar x-ray:
1. status post paired pedicle screw and rod fusion L2-through S1.
2. chronic compression fracture of L1 with advanced chronic DDD at L1 subchondral sclerosis and large marginal spurs.
3. status post intervertebral body fusion L4-5 with grade 1 anterolisthesis and no sign of instability on flexion or extension.
4. moderate levoscoliosisMy first surgery in 2001 was for a small herniation in L-4 L5. The surgeon left the spine unstable…..did a hemilamie (spelling)
My spine shifted like a stack of plates.The second was in 2003 for stabilization by fusion, by another surgeon.
He put what others are saying was wayyyy to much hardware and went into thoracic to “explore”. Thus RFA was unable to be utilized.Over these painful years, I was told not to have any more surgery. Now, I am told there is no choice. But I can see and feel that for myself.
In the interim, my thyroid had to be destroyed with 30 mci radioactive iodine. I was told it was toxic, but not why.
I am now learning to ask questions, (too bad, after the fact) but in many cases, I do not get answers…they are evaded.I also had to have a complete hysterectomy in 1995. Just saying.
I feel cursed. And definitely scared to death!
I appreciate your help.
Thank you,
Mary~”Thistle”Motor weakness for the L5 nerve would be gluteus medius, peroneal, extensor hallicus longus (EHL) and tibialis anterior weakness. EHL weakness is not that important as it is not a very important muscle except in certain unusual occupations.
The major weakness of L5 that would affect day to day life would be weakness of tibialis anterior. This causes foot drop; the inability to keep the foot up on heel strike during gait. This is tested simply by walking on your heels while keeping the feet up off the ground. If you cannot keep the ball of the foot from touching the ground while doing this test, there is weakness.
S1 weakness would affect the gastroc-soleus group (calf muscles) and the hamstrings. Testing this is simply by toe walking. If while walking on your toes, the heel on the affected side drops (it doesn’t have to touch the ground), there is weakness.
In either case, this is an indication of the need for decompression sooner than later.
Cauda equina syndrome is another matter entirely. This is caused by a massive herniation that compresses the entire canal and causes bowel and bladder dysfunction. This is an urgent matter but by the description of your herniation, you do not have this syndrome.
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.#6616 In reply to: standard mri vs stand up nd chronic back pain helpp |my pain in in the lower back with the bottom two joints which are i guess the sacroliac joints , in the mid upper back by the shoulder blade and spine and in the neck. this pain is radiating throughout my whole body mostly my right buttock and down the tigh to the legs. the quality is pain is so bad its ruined my life i can barely move from it. the pain constantly changes its form sometimes its sharp , stabbing , sometimes aching and other times when its really bad its almost everything. i cant even look down with my neck to touch the chest when i try this my whole back just feels like im ripping a muscle into two and pulling something very hard it starts to burn and stab. with it i also have very bad fatigue weakness and muscle pain with muscle spasms. in the mid upper back near the shoulder blade there is a very tight muscle that feels like a rope when touched that comes from the lower back joint to the neck . when i try to squeeze my shoulder blades together i hear very loud clicks and pops, besides this when i breath my mid back contracts and the pressure comes right in the middle of the spine and pops. the percentage of back pain is 80 percent with the legs and buttocks with 20 percent. i know i have something very serious going on . because it has disabled me and stiffened me as well. the intensity of pain is 10 all the time never comes down if there were a number to describe more than 10 i would. because of my pain i have been limping when i walk for 6 months now and daily it progresses more and more . the pain first started in the neck with just stiffness i was able to do everything but then later it started to move into to my lower and gradually increased everywhere. im wondering if it had anything to do with my other illness. i also have rheumatic fever and i think rheumatoid arthritis that im being checked for. my doctor put me on a cane to walk because my joints have been damaged and they don’t take anymore pressure. is there any blood test that i can o for my back to see whats really causing it. i haven’t been pain free for 9 months constantly and now im on anti depressants because of it. i even left school work and sports all because of this . ive had no treatment so far only painkillers. thank you
#6609 In reply to: standard mri vs stand up nd chronic back pain helpp |The stand-up MRI is distinctly poorer in image quality and information gathering. Yes, the image will demonstrate what effects gravity has on the spine but with poorer image resolution which significantly diminishes the information.
A good supine MRI (standard type) along with standing X-rays (including flexion and extension) will yield better information regarding pathology and the effects of gravity on the spine.
By your description, I am unclear if the pain originates from your lower back or your mid back (thoracic spine). Please see the section under “Conditions”; “How to describe low back pain” for a template to describe your symptoms.
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.#6561 In reply to: Pain from left hips down the legs |Your MRI notes a right disc herniation compressing the right L5 root in the lateral recess. See the website under lateral recess stenosis to understand what this is.
You complain however of LEFT sided hip and leg pain that increased with extension (bending backwards). The causes of left leg pain increased with bending backwards could be from foraminal stenosis, lateral recess stenosis or an isthmic spondylolisthesis. See the website for those descriptions.
The radiologist might have mis-dictated the side, missed a foraminal stenosis on the right or you might have instability that only a flexion/extension X-ray can pick up.
You need further consultation.
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.#6558Topic: Pain from left hips down the legs in forum BACK PAIN |hi im randolph 21 yrs old. ive been suffering on my left hips pain down through my legs. the pain feels likes my nerves is being stretched every time i walk straightly also everytime i go to bed and lay down straight i feel so much pain. i already go to an orthopedic and try some movements to see what could be the cause of my pain. he bend me forward the pain seems not to painful. but when i bend backward just an inched the pain shot me. feels like a needles or electric shock. he said i should go to MRI and i already do. MRI findings:
– There is straightening of the lumbar lordosis.
– Vertebral height and marrow signal are preserved.
– The visualized spinal cord is normal in size and signal intensity. No abnormal cord signal is seen.
– L4-L5 disc shows loss of hydration signal. There is right paracentral disc extrusion with inferior extension obliterating the right subarticular recess and impinges the traversing nerve root. the rest discs are intact with normal hydration and without bulge or protusion. the rest of the spinal canal, neural foramina and exiting nerve roots are within its normal limits.IMPRESSION:
1. STRAIGHTENED LUMBAR LORDOSIS.
2. L4-L5 DISC DESICCATION AND RIGHT PARACENTRAL DISC EXTRUSION OBLITERATING THE RIGHT SUBARTICULAR RECESS AND IMPINGES OF THE TRAVERSING NERVE ROOT.dr. that is my finding of my MRI. plss help. i cant even go to my orthopedic doctor for him to see my findings. plss help im so worried with my condition. i cant even play with my little boy. im so sad. tomorrow is my birthday i dont know if i can celebrate with full energy because of my condition. plss help thank you and godbless you.
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