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Please help me understand my MRI report

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Unread 11-06-2012, 08:58 PM   #21
tdouglas
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Originally Posted by Dr. Smith View Post
Please keep in mind that no-one here has a medical degree or any status as far as medical opinions go. Whether someone warrants or requires surgery is the call of the patient with the advice/counsel of his/her doctors. If a doctor takes a wait & see position, there may be good reason. I'd have a frank discussion with the doctor rather than making an assumption.

If someone isn't happy with their doctor for any reason, they always have the right to second (or more) opinions, and/or to go to another doctor.

Doc
Oh, I definitely get that. I'm just asking you guys for your thoughts, since I'd like to 1) know what I'm dealing with and 2) plan out all the questions I need to ask my doctor. If my doctor suggests surgery, I'll definitely get at least one other opinion. I know a laminectomy isn't a very reliable surgery (I think I read 60%-70% success rate). But then again, I don't even know if that's the surgery I would need.

I hate not being able to ask a doctor all these questions right away!
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Unread 11-07-2012, 02:26 AM   #22
Dr. Smith
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IMO (and the opinions of others on this forum, none of us being doctors, but all of us being patients) surgery should only be considered:
  1. After all other therapeutic options have been tried & failed
  2. After careful consideration of multiple medical opinions
  3. If not having surgery would result in permanent damage (e.g. paralysis)
(subject to correction/discussion -- I'm a little distracted this evening and not at my best)

I have "severe" stenosis and discs so degenerated I have 'bone on bone' in my cervical (c5-c7) and lumbar (l3-s1) regions and in both cases, my doctors have advised against surgery for me, citing that the risks, in my case, outweighed the potential benefits (better than 50% chance of my coming out the same or worse). This was several years ago, I get periodic follow-ups, and their opinion has not changed. Looking back, even through the pain and disability, I don't regret not having surgery; it will always be an option, but it can never be undone.

Surgery can correct physical abnormalities; it cannot always eliminate pain.
Quote:
Several recent studies have shown that the chronic pain management approach can be as effective in treating spine pain as spine surgery.
http://www.spine-health.com/treatmen...hich-right-you
Back/spinal surgery is the only type of surgery I'm aware of that fails so often they actually have a name for it -- Failed Back Syndrome

See also: Failed Back Syndrome: The Disturbing Statistics

Doc
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Dr. Zachary Smith
Oh, the pain... THE PAIN...

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All opinions expressed are my own. For medical advice/opinion, consult your doctor.
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Unread 11-07-2012, 02:37 AM   #23
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Originally Posted by tdouglas View Post
I hate not being able to ask a doctor all these questions right away!
That's good. I hope you like to read & learn!

Questions to ask before spine surgery

See also the related searches at the bottom of the first page.

Doc
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Unread 11-07-2012, 05:40 AM   #24
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Quote:
Originally Posted by Dr. Smith View Post
Please keep in mind that no-one here has a medical degree or any status as far as medical opinions go. Whether someone warrants or requires surgery is the call of the patient with the advice/counsel of his/her doctors. If a doctor takes a wait & see position, there may be good reason. I'd have a frank discussion with the doctor rather than making an assumption.

If someone isn't happy with their doctor for any reason, they always have the right to second (or more) opinions, and/or to go to another doctor.

Doc
Quote:
Originally Posted by Dr. Smith View Post
That's good. I hope you like to read & learn!

Questions to ask before spine surgery

See also the related searches at the bottom of the first page.

Doc
Wonderful advice from the wise "Doc" as usual. Great information sites were given. Read Read Read and celebrate that you are dealing with this now, when you can access so much information. I believe that ignorance, not the pain, is your worst enemy. Best wishes.
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Unread 11-08-2012, 01:27 AM   #25
joschildt
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Default Trying to figure out my MRI

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Originally Posted by ginnie View Post
The biggest" issue", are the ones that state Severe. However, if surgery gets to be the option you need, those verterbre need to be in good condition. So write this question down at the top of your list to ask the neurologist. Get details from him, let no question go unanswered. For the best results, and confidence, you need all the truth in detail, and real dicussion with your doctor. It will be OK, even if you have to have the surgery. None of it is fun, but a life in pain isn't either. I had a good outcome with my surgery, so I know for sure, that this is possible. I would hesitate on alot of PT at this point, until you get more information. Not all PT works for spinal issues. I did this, and it made my condition worse. If it hurts Stop. Ask your doctor OK?
Keep us posted. All of us who have had spinal fussions or back issues do care about you. Hope you have some good support there at home too. Keep us posted. ginnie
I just had a MRI done on Tuesday and the reason why I had that done was the bottom of my feet from the ball to my toes they feel like the fell asleep. I have to move my toes a lot just to start feeling them again. My lower back is in pain if I stand too long and then I feel like I'm about to collaspe. I have that much pain I get shooting pain into my hips and down to my knees. My results say something about mild disc dessication and degeneration at the L5-S1. Also it stated something about the L1-L11 L2-3 levels are unremarkable. It also had stated that my L3-4 level there is slight compromise of the lateral recess bilaterally with mild facet joint prominence. my L4-5 there is a diffuse annular bulge with slight ventral flatting of the thecal sac. And my results go on and on. I dont understand what that says except maybe I have a bulging disc. If anyone knows what this says I would be greatful.
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Unread 11-26-2012, 12:42 PM   #26
tdouglas
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Here's an update:

I saw a neurosurgeon today. He recommended a few weeks of physical therapy and a steroid injection. He said that if I wasn't feeling better after those few weeks, he would recommend surgery. It didn't sound like he was optimistic about me finding relief outside of surgery.

Unfortunately, my insurance doesn't cover physical therapy, so I'm trying to figure out what to do about that.
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Unread 11-26-2012, 01:55 PM   #27
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Hi, and I sure hope that I can help you. My son is an OPTA, does therapy of this kind. I could ask him about different excersises and therapy if you would like. He may be able to print some specifics out for you. I would be willing to ask him. I would not go to a chiropracter, unless your neurologist recommended it at this time. Steriod shots, well after all the trouble there has been, I am not sure about them at this point. They in any case are a temporary fix, and if there is a real issue with the back, they do not last long. I had Ketamine infusions which did OK for about 4 months each. I had surgery after that. Massage is also a good part of PT. If you can get massage, it is alot less expensive than PT. I wish you all the best. ginnie
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Unread 11-26-2012, 10:13 PM   #28
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Originally Posted by ginnie View Post
Hi, and I sure hope that I can help you. My son is an OPTA, does therapy of this kind. I could ask him about different excersises and therapy if you would like. He may be able to print some specifics out for you. I would be willing to ask him. I would not go to a chiropracter, unless your neurologist recommended it at this time. Steriod shots, well after all the trouble there has been, I am not sure about them at this point. They in any case are a temporary fix, and if there is a real issue with the back, they do not last long. I had Ketamine infusions which did OK for about 4 months each. I had surgery after that. Massage is also a good part of PT. If you can get massage, it is alot less expensive than PT. I wish you all the best. ginnie
Thanks, Ginnie. I would certainly appreciate your son's opinion on which exercises to do. I'm not too confident in the steroid injections, but I want to make sure I try conservative methods before resorting to surgery.
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Unread 11-27-2012, 01:17 AM   #29
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Quote:
L4-L5: There is a disc bulge with superimposed central disc extrusion. There is mild bilateral facet arthropathy. There is no neural foraminal narrowing. There is severe central canal stenosis.

tdouglas,

You have a central canal that is severly choked down. Only your clinician knows your exam findings and can make a determination for ESI or not. But if conservative management, oral non-steroidal and steroidal anti-inflammatory medication, PT, etc., has all failed, then why not go for the ESI?

I can't tell you how many times I've seen such a procedure drag someone out of the depths and despair of surgical consideration. ESI too may fail, but if your doc is recommending it, at least you won't go into (potentially) surgery without a fight! And believe me that ESI is a hiccup compared to the inconvenience and disruption to your life that decompressive surgery would be!
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Unread 11-27-2012, 01:32 AM   #30
gatorhead
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Because it is so centered, would I be able to just let it heal on its own? Or can it move to paracentral left/right? And hearing that you haven't had to get the surgery is reassuring. Did your doctors recommend the surgery, and what did they say was the worst thing that could happen if you don't have the surgery?
I am sorry that I missed this until now. Could it heal on it's own? There are some studies that suggest that they could heal themselves if they are bulging and not torn or prolapsed. This can be achieved by physical therapy and injection type therapy. I personally think the injection therapy is something they are forcing down our throats because they can charge and be paid for an outpatient surgery! I have not had personal success with either, and I don't know a single person who has and I know A LOT of spine patients!

Can it move left or right? It can in essence, if it were to prolapse or for a lack of a better analogy, terminology, and visual reference, squirt out and move left or right. I would be referring to the nucleus here and it it what mine did only because it had no where else to go. It stays in the general area, and that area isn't large at all. It could be positioned more to one side or the other and still remain central. That was harder to explain than I thought lol

The doctors are on me to have the surgery, YES! I have not had it, and I will not have it until I 1. can't take it no more 2. can't walk at all 3. defecate on my shoes. Kinda graphic but that's how I feel. My mom had her's fused in 82 and I grew up watching that nightmare scenario unfold so for me it is an ultimate last option. I have had 2 neck surgeries now, those were necessary and unavoidable (VERY similar to your condition only in my neck). What I have been told about the back at those locations is that it could permanently affect bladder/bowel function, walking, and sexual function.

That all being said I agree with the other's it is a case by case scenario. True I am not a doctor, but I am very well versed with these things as is most other's here from having to deal with it first hand. I can also tell you that what I saw on your reports your surgeon seemed to see the same thing, it is severe central stenosis. What makes this a problem is your cord is being compromised and at a point where, not the pain, but the preservation of the cord is at risk. There is no more room for error. The type of surgery most often used for this is decompression or laminectomy. However if there is any sign of DDD then they will most likely want to fuse. All of that being said I would have a thorough discussion with the surgeon and ask EVERYTHING you want to ask and he/she should be able to answer them all immediately and appropriately. I always recommend a second opinion to a surgeon OUTSIDE of that hospital or medical firm completely independent of the first.

Not trying to scare you or be doom and gloom, just trying to put it into layman's terms. I will pray for you and I wish you the best. PLEASE get that second opinion soon!
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