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in reply to: Severe Coccyx pain that is affecting rectal area #34233
Dr. Corenman
i think i am done with medical tests! i just received my report from my CT scan with and without contrast. This was done for Renal mass protocol.(incidental findings on MRI) so the office that ordered it stated they were short staffed and the nurse read my findings to me and said there were no concerns, but she would check with the Dr. to confirm and call me back if there were any. I am not a medical professional nor do I understand any of it, so i am just at their mercy. it only mentioned one part of my spine though, it states:
Included osseous structures are intact with post surgical change of fusion at the L5 S1 level..so I am assuming that is good. nothing else was mentioned about it. So now i just wait to hear back if i need to be concerned with other findings .. such as enlarged liver measuring 17.7cm in length and whatever a ventral hernia with bowel protruding through this area is. She said there was nothing of concern so i will rest easy with that information. We will just do the PT and keep strengthening my core with my exercises and walking. I can deal with the hip pain and i am used to not being able to sit very long now. I have alot of experience shifting and standing. Thank you so much for all of your help, i hope that i do not have to ask any more questions. You have truly been great and made me more comfortable going in to my fusion i had last year. Take care. Oh.. the renal lesions came back simple except for some smaller ones in the other kidney they could not determine because they were so small. so at least i know they are just simple and i am assuming fluid filled.in reply to: Severe Coccyx pain that is affecting rectal area #34214Thank you so much.. Surgeon said he fused L5 S1? I confirmed that with him after surgery because i was confused as well. i just dont understand the report nor am i able to make anything out of images on my CD so no use in me even trying. I am currently awaiting my results from the renal mass CT from urologist. I see my surgeon again in October after going to PT (aquatic) and continuing the ibuprofen. I am just struggling with pain in what I call my hip and he calls my SI joint. If i want to go upstairs in my home, i have to crawl up with my hands. LOL crazy but it does not hurt that way so i am okay doing that if necessary. I was just wondering if sacralization could cause issues with that joint? i dont know.. i will need to follow up with him in October. I think i can deal with it until then. No more long car trips or anything coming up soon thankfully. I so appreciate your time in answering my questions and concerns. Not sure if the CT on my abdomen will show my lumbar part of my spine or not, probably not since they are not really looking at that right? Thanks again for your reply
in reply to: Severe Coccyx pain that is affecting rectal area #34205Dr. Corenman
Good afternoon
I had my MRI completed last month and saw my surgeon a couple of weeks ago. Described my discomfort to him and he did some tests on me there in the office. He said it appeared to be sacroilliac? prescribed aquatic PT again and to stay on the gabapentin and ibuprofen 800mg. we will revisit in 3 months. I dont feel near as bad as last year and he told me i am free to do what i want just to use my commone sense. He wants me to live my life, that is why we did the surgery. Although I am not able to actually live my previous normal life, but i can do more things now. Here is what causes me issues, i am not able to climb my stairs like normal without pain on the left side. i cannot sit but just for a few minutes before the aching and hurting starts. I can walk pretty good just across standard flat surfaces.. so i do still go for walks every day. I have to take the ibuprofen and the trezix everyday. Overall he said everything appeared fine. I can only copy what the written report says. i still have this leg pain and what i call Hip pain which dr says is not actually my hip but my sacroiliac joint?or something like that. I am back to not being able to ride very long in the car or sitting for more than 10 to 15 minutes..but if i dont move it takes longer to get going once i am up. ugh.. 7/9/2021 Thank you so much for your time and reading this.
Report ViewReport
Accession No. Patient Name/ID Study Date Sex/ Age Institution
Other Patient ID My Comment(s) Study CommentsEXAM TYPE: HF MRI LUMBAR SPINE WO CON
HISTORY: 049Y female with Z98.1:Arthrodesis. History of lumbar fusion 1 year ago per the patient.
Ongoing left-sided lower back pain, symptoms in the left leg.
COMPARISON: MRI of the lumbar spine of 05/27/2020.
TECHNIQUE: Multiplanar, multisequence MR imaging of the lumbar spine was performed without IV
contrast administration. FINDINGS:
To be consistent, the prior nomenclature will be used for this exam. However, prior to any surgical
procedure of the spine, confirmation of this nomenclature with radiographic survey of the entire
spine is recommended. The L4-l5 disc space is the caudal most well-formed disc space, and there is
a rudimentary disc space which is smaller at L5-S1. LS appears sacrailzed on the left and
sacralized or partially sacralized on the right. Intervai posterior fusion changes noted at L4-LS
with metallic hardware/artifact mildly degrading evaluation at this level, the disc space is not
well assessed.Lumbar alignment is preserved. There:c no significant listhesis.
‘ • -.. ..
No acute fracture, compression deformity,- or frank aggressive osseous lesion.The conus medullaris terminates normally at L1 level. The disc heights and hydration appear
maintained from T12 through L4. ·
Evaluation of the individual lumbar levels demonstrates:
Ll-L2: No posterior disc herniation, thecal sac or foraminal stenosis. Minimal left facet arthrosis
L2-L3: No posterior disc herniation, thecal sac or foraminal stenosis. Minimal left facet
arthrosis. L3-L4: Mild facet arthrosis with similar mild/trace left joint effusion.
L4-L5: Mild contouring of the ventral thecal sac is slightly right eccentric, stable, and midline
AP thecal sac diameter is 12
mm in AP dimension. The contouring may be due to postsurgical changes, not well assessed by this
exam. Interval increase patency of the subarticular recess is noted bilaterally. Very minimal
ventral flattening of the left descending nerve sheath
noted, possibly by osteophyte/osseous hypertrophy, which abuts the descending left nerve minimally.
Lateral masses are not well assessed.L5-S1: Axial images d, o not include this level, however there ls no thecal sac or foraminai
stenosis demonstrated on the sagittai images, and no significant posterior disc herniation. No
significant facet arthrosis. No significant interval change.
Right renal lesion 1.5 cm atleast, is not well assessed, with possible peripheral wall thickening
versus artifact, arid may be
enlargedcompared to prior exam. Correlation with.CT renal mass protocol without and with contrast
is recommended. Anot” -:r right renal lower .pole lesion is 1 cm g,ossly stable. . ..
. .. , · .·· · ·.·
IMPRESSION:
Interval postsurgical changes of the disc space with posterior decompressive changes and posterior
fusion metallic hardware noted at L4-L5.
Interval increased patency of the right and left subarticular recE>.sses, with possible minimal
osteophyte or osseous hypertrophy at the posterior margin of LS, minimally abutting the descending
left nerve without contouring it.
Otherwise, the remaining Ll through L4, and L5-S1 levels are not significantly changed.
Transitional lumbosacral anatomy as described above. Nomenclature on this exam is consistent with
nomenclature on reference MRI of 05/27/2020, however prior to any surgical procedure of the spine,
confirmation of this nomenclature with radiographic survey of the entire spine is recommended.
https:1/pihulite.infinittna.com/worklist/Report1/2
7/9/2021
Report ViewRight renal lesion of at least 1.5 cm with possible peripheral wall thickening appears enlarged
compared to prior exam. Correlation with CT renal mass protocol without and with contrast is
recommended to assess for suspicious features.
Similar appearing right renal lower pole lesion of 1 cm.2/2
in reply to: Severe Coccyx pain that is affecting rectal area #34151Since it took me a while to notice your repsonse and attach to my original thread.. i have seen the doctor. My xrays look good and hardware is all in place. new MRI has been ordered and waiting on them to schedule. I am back on the gabapentin and they also put me back on the Trezix as needed as well as the 800mg of ibruprofen. I am managing fine and still walking daily (5miles) i have put the weights down for now just to be on the safe side. the one thing that is different regarding the left leg pain is the stangest feeling of something wrapped around the bottom of my leg, mostly near my ankle. i can describe it as maybe like a rubberband or something tied around it? veyr strange and it bothersome at times. But overall still better than I was a year ago this time. thank you so much for your time.
in reply to: Severe Coccyx pain that is affecting rectal area #34150Good afternoon Dr.
i did not use my original thread from months ago..(titled severe Coccyx pain) as i do not have that any longer. the 2nd injection back in December worked really well. I am only just now having some of that discomfort come back and pain dr. said he would burn the nerves next time if needed. Anyway.. i am always hearing about Flare Up? my question is how do you determine if it is just a flare up? I was told from a surgical standpoint i no longer had restrictions (back in November) so i went on vacation and have been living life normal. I am careful and do not get carried away with things. i started back exercising and small weights. (16lbs total) I am up to 4.5 miles pe60 r day walking. I love to walk, it is the best exercise i get. I have managed to drop another 20lbs since my 360 (L5 S1) fusion last June. I noticed about 5 weeks ago, that i started feeling low back pain. Not as intense because it is not keepin me awake at night. Leg pain is awful though! Same left leg as before.. i am not taking anything other than gabapentin 300mg at night before bed and 800mg of ibuprofen. this is driving me crazy.. and i am concerned and have been taking it easy for the past few weeks. I do not want to experience that type of back and leg pain ever again. It has not let up but has not gotten worse either. I am worried about it, so called the doctor and they said i could be in a flare up? how do you know? thank you so much for your helpin reply to: Severe Coccyx pain that is affecting rectal area #33119Good morning from Texas Dr.
I am now a little more than 3 months post op of my 360 lumbar fusion. Things are better and the terrible low back pain is definitely better than it was. I was mistaken on the level that was fused. My MRI report stated L4 L5 however my doctor said it was L5 S1. I asked and he said he goes by the MRI not the written report. Although my report did mention something about L5 on Left is sacralized and right is partially sacralized so confirming the level prior to any intervention would be reccomended..so that is probably why I had it wrong. Either way the pain is alot better now.. not gone completely, but manageable with Ibuprofen. About a week ago I noticed I have the pulling feeling again in my left leg, and i can only stand up for a little while because i get that burning feeling in my foot. I can pretty much handle it as it comes, but it does cause me a little problem. I still cannot sit properly or ride in a car due to the pain my seat area. I can sit forward without putting pressure on it and I am fine, until the burning starts in my leg because of the way i am forward in the chair.. so i can stand for a while and then only sit leaning forward. I cannot go very far in the car as its just too painful. so the most i will drive is to town and appointments. I think i am going to have to live with this as i already did a round of steroids and i take Gabapentin 3 times a day and one muscle relaxer at night. I do have Tylenol with codeine prescribed to me, but i dont take that unless its an absolute must. I dont like the way it makes me feel and i cannot work properly on it. My question actually is this.. would a surgeon fix or take care of anything else during the procedure? I know per the report i had a disc protrusion contacting the exiting L4 nerve root and 4-5 mm synovial cyst contacting the desending left L5 nerve root.just curious because after December 31st.. i am done. In the last year I have had to spend 13K of my own money on deductables.. and i just cannot do that again.. so i will have to live with whatever i have left wrong and pray it just gets better with PT and stretches. I have not even had my left arm looked at. it still throbs and thumb and index finger go numb.. but I can live with it as long as it doesnt get any worse. Thank you again for reading my small book. -
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