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  • Littleshell09
    Member
    Post count: 7
    in reply to: Treatment options #11563

    Yes Dr Corenman you did answer that one twice. Sorry about that, I’d thought the first hadn’t posted. So thank you for your responses. I’m just wondering if you think an anesthesiologist might have more experience with this than a physiatrist? Obviously, this area being so close to vital vessels, nerves, etc I’d want someone very experienced. If I’m understanding the process correctly, injections can be repeated every few months? Is there any impact on an already existing osteopenia? When I started looking for a PM I focused on experience with this type of problem. I’m understanding that it’s a rare occurrence. Anyway, thank you again & I’m guessing it’s ok to ask the MD directly just how many they’ve done for this problem.

    Littleshell09
    Member
    Post count: 7

    Thank you for the response. I’m wondering if surgical intervention might be warranted? I’m really uncomfortable most of the time & unable to engage in activities which previously added to my quality of life. My legs hurt badly when climbing stairs, sleep is interrupted, etc. Physical Therapist suggested I should seek surgical consult as movement was so difficult. The lumbar area “catches” & I can’t move. My family is tired of seeing their once active mom so limited. I had a recent problem with my R knee & the Ortho felt the back may be lending to that syndrome as well. I feel grateful for your thoughts.
    Respectfully,

    Littleshell09
    Member
    Post count: 7

    Pain continues, inadequate relief. NSAIDS cause severe esophageal & GI gastritis, confirmed by gastro specialist … What can you recommend at this juncture? I’m in severe pain daily & my QOL is greatly reduced. I’ve been offered flexeril 10 mg HS, cymbalta – that’s about it. Is there adequate justification here for the pain I’m experiencing? Thank you!
    Health Record: Reports

    Patient:
    Reports

    For more information about a report, please contact the Ordering Provider. [More]
    Report

    Print
    Exam Number: A13315085 Report Status: Final
    Type: MRI SCAN LUMBAR SPINE WO CONT
    Date/Time: 12/14/2013 13:10

    REPORT:
    INDICATION: Chronic severe pain. Per EMR, low back and bilateral thigh pain.

    TECHNIQUE: MRI of the lumbar spine was performed on a 1.5 T
    magnet without intravenous contrast. Sequences include sagittal
    T1, sagittal T2, sagittal STIR, axial T1, axial T2.

    COMPARISON: None.

    FINDINGS: Study assumes 5 lumbar type vertebral bodies.
    Vertebral body heights are preserved. Conus terminates at T12-L1
    and cord signal is normal. There is multilevel intervertebral
    disc desiccation and moderate intervertebral disc narrowing at
    L4-L5. At T10-T12 and also from L2 to L4, there is also
    Schmorl’s node formation. Focal T1 and T2 hyperintense signal
    within T12 is either a hemangioma or focal fat (se 3, im 11).
    There is mild anterolisthesis of L4 on L5 measuring 3 mm.

    Specific findings are seen at the following levels:

    T12-L1: No significant disc herniation, central stenosis or
    neural foraminal narrowing.

    L1-L2: No significant disc herniation, central stenosis or neural
    foraminal narrowing.

    L2-L3: Facet arthropathy. No significant disc herniation, central
    stenosis or neural foraminal narrowing.

    L3-L4: Facet arthropathy. No significant disc herniation, central
    stenosis or neural foraminal narrowing.

    L4-L5: Severe facet arthropathy with fluid signal within the
    bilateral facet joints as well is a small, tiny 1 mm left
    intracanalicular synovial cyst result in mild bilateral neural
    foraminal narrowing, as well as borderline mild central stenosis.

    L5-S1: Facet arthropathy. No disc herniation, central stenosis or
    neural foraminal narrowing.

    SACRUM: No significant abnormality seen.

    Miscellaneous: Paraspinal muscles are unremarkable. Subcentimeter
    probable right renal cyst. Status post cholecystectomy. 7 mm
    rounded T2 hyperintensity in the mid abdomen adjacent to the
    liver seen on scout images (series one image 4) which may
    represent volume averaging with bowel, but is incompletely
    imaged.

    IMPRESSION:
    1. Severe L4-L5 facet arthropathy with mild bilateral neural
    foraminal narrowing and borderline mild spinal canal stenosis

    Report Status: Final
    Type: Lumbosacral Spine Min 4 Views
    Date/Time: 06/13/2013 12:18
    Exam Code:
    Ordering Provider:

    HISTORY:
    Backache –

    REPORT AP, Lateral and Bilateral Oblique Views of the Lumbar Spine

    COMPARISON: None.

    FINDINGS:
    There is anterolisthesis of L4 on L5 which measures 7 mm in flexion
    and 4 mm in extension. Vertebral body heights are maintained. There
    are mild endplate degenerative changes. Facet degenerative changes
    from L3-S1.

    There are bilateral sacroiliac joint degenerative changes. Surgical
    clips are noted in the right upper quadrant consistent with prior
    cholecystectomy.

    IMPRESSION:
    Anterolisthesis of L4 on L5 with increase in flexion as above.
    Associated facet degenerative changes. Posterior elements appear
    intact.

    ***

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