Pafrmboy

He looked at a previous NCS/EMG from a few years back. Should I have another one? Maybe he will want that after he gets the labs.

Thanks for your opinion again….much appreciated. I will have to just pin the neuro doc down. Or better yet, maybe see a 3rd one.

Best regards, Todd

Hello again Dr. Corenman… It a bit over 3 years now since I posted and I am still struggling with my back/nerve/gastro issue. From my 1st post, I would like to correct that that loss of orientation I eluded to when I was running, was actually numbness. At 3 years further out now, I have BOTH medial gatros with near complete atrophy. My right lateral gastro is less than 20 percent in my opinion and my left gastro is about 50 percent. I have severely impaired gait and balance issues. My upper leg strength is intact. I favor to the left, as that is the stronger leg and because of that, I feel that I am weakening the right a little more. I do get near daily sciatica pain in the LEFT leg with some foot numbness, but that pain is low and in the 2-3 range. I have been to a neuro surgeon that I know and have worked with and trust. (I’m an RN, masters level) and he did not feel that there was a surgical issue with me. When returning to the neurologist, he felt that there WAS a surgical issue and then ordered a new MRI (with motion) to better see this. That MRI dictation is:
The conus medullaris and conus equina are intact.
L1-L2 Shows no evidence of central canal or foraminal narrowing.
L2-L3 There is no evidence of central canal or foraminal narrowing.
L3-L4 There is no evidence of central canal or foraminal narrowing.
L4-L5 This level shows a modest circumferential disc buldge of 4.1mm slightly impinging on the thecal sack and producing mild foraminal narrowing on the right.
L5-S1 This disc level is narrowed and the disc end plates are slightly irregular. There is a broad based HNP of 4.2mm greatest in the left parasagittal plane and producing modest impingement on the thecal sack. There is no evidence to suggest spinal stenosis or foraminal narrowing.
There is total lumbarization of S1 with S1 and S2 being unremarkable.
Conclusion:
Diffuse 4.1mm disk bulge at L4-L5 producing mild right foraminal narrowing, but no evidence of central canal or other areas of significant narrowing.
Decreased L5-S1 disc space with irregular somewhat edematous enplate. There is a 4.2mm left parasagittal centered HNP with no significant spinal or forminal stenosis produced.
Total lumbarization of S1 through the disk level is otherwise intact.
Flexion and extension views show no changes in the bulges, nor in the disk space alignment.

A second neuro doc says that he also feels that it’s a surgical case based on all the clinical facts and presentation.

I manage to get all of life’s chores done, but feel now that the right leg is getting far to weak for my comfort. Yet I have conflicting medical opinions. I’m at a loss.

As I remember back to my youth, I remember having sciatica as early as 16 years old and then at 20 and then every 5 years or so it would flair up. (I’m 51 now) Could it possibly be that my anatomy is just small and it does not take much to cause symptoms? This round of weakening/atrophy started in 2009 and has taken 7 years for me to get to this point. I would value your opinion and suggestion.

Thanks, Todd