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Back pain , numbness in legs

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I am posting this for a friend. All replies are welcome!! I've edited for brevity as best I can, thanks for taking the time to read:


First email:



My legs started going numb when I was driving about 3 weeks ago….especially my right leg.

I finally got a referral to a neurologist who did an MRI.

She said that there is a cyst on my spine….or something like that.

She also said something in my spine was not entirely “closed” and that is how the cyst eventually developed?

I didn’t quite understand her.

She said that the only way to correct the problem is with surgery but they don’t like to jump into back surgery anymore….because a lot of times it does more harm than good.

She said it was totally up to me (and I know absolutely nothing).

So, I asked her what would happen if I just kept going around with legs that felt half asleep.

I asked her if the numbness could become permanent or get worse.

She said, “I don’t know.”

I asked her if it would be better to do surgery then.

She said, “I don’t know.”

I asked her if the cyst might go away on its own.

She said, “I don’t know.”

Every question that I asked, she said, “I don’t know.”

How could I make a decision with information like that?


Second email:


Even though I said it was my back….the neurologist insisted on doing a double MRI….of my back AND my brain.

The reason that she wanted to MRI my brain is because she asked me what day it was and I said “July 7th”……and it was August.

Then she did some weird left and right test with me, and I got confused of course.

I have never been able to tell left and right (unless I have time to think about it).

Mom took a black pen and made a dot on my right hand when she sent me off to school, so I wouldn’t forget which was which.

Anyway, my normal mental “driftiness” distracted the neurologist.

So, I had to get 2 MRIs, to make her happy.

She thought I had a brain tumor or something. I guess brain tumors will also make your legs numb.

BUT…I was right and she was wrong.

She didn’t need to check out my brain…..there is nothing wrong. It’s apparently just the way I am.

My back on the other hand, is another story.

She didn’t give me the whole details of what kind of cyst it is.

I am supposed to go back on the 23rd of September and get an “EMG”. (not an EKG).

I have no idea what an EMG is.


Third email:


I didn’t have any information, because all the information that the neurologist gave me was, “You have a cyst on your spine. Do you want surgery or not.”

There is no way I could make a decision like that.

I don’t know anything.

I tried looking it up on the internet---and then I found out there are all kinds of different cysts and back problems.

And there are a lot of failed back surgeries too.

Since I didn’t have any detailed information, I went back to the clinic today and asked the nurse at the front desk for a copy of the MRI.

I told her that I might want to go to a chiropractor, so I needed something to show him.

All I know is that my legs are numb and it is making driving and (sitting for any period of time) frightening.

Here is the info:

“On the coronal localizing images, the patient is noted to have a mild dextroconvex thoracolumbar scoliosis.

At L4-L5, there is a 5 mm synovial cyst arising from the left face joint and encroaching on the left subarticular recess region. There is a moderate degree of left subarticular recess stenosis. The left L5 nerve root would appear to be impinged upon. There is a mild to moderate degree of right subarticular recess stenosis secondary to chronic degenerative disk disease. The right L5 nerve root may be adversely contacted. The neural foramina are patent.

On L5-S1, there is mild to moderate facet arthropathy.

Impression:

The patient has disproportionate spondyloarthropathy at L4-L5. Clinically significant relationships may be present. “


Thanks all!!! nurse Very Happy
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replied September 6th, 2008
Community Volunteer
EMG
This is interesting however they only answer I can give is to what is an EMG.

It is a test for a neurologist to register signals from certain areas to your brain. Are they slow, normal or none. I've had one due to numbness, tingling and weakness in my legs and tingling in my arms. It is helpful tool for the neuro to pinpoint causes of these types of symtpoms.

It involves needles, very, very, very thin needles....about the size of what an acupunturist would use.

The only discomfort that I experienced was when they put a needle at the base of one of my thumbs...it only lasted a second or two.

Back surgery? I have heard too many horror stories...it would be my absolute and I mean absolute last resort.

And for a doctor to say "I don't know" over and over...that in itself is quite unsettling and to suggest surgery...could she be looking for some on the job training?

2nd and 3rd opinions I would seek...

I wish your friend the best,

~Zig
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Users who thank zigemyster for this post: mominashoe 

replied September 7th, 2008
Extremely eHealthy
First thing I would say is get another spinal surgeon ASAP. This doctor is not one that you would want to use and doesn't seem to understand what is actually the problem or how to determine what should be done.

An EMG is a test with tiny needles like Zig said, and it is done to see if there is any nerve damage in particular areas of the body or if nerves are involved in a medical situation.
It can be uncomfortable to be done, but nothing terrible. I've had them done myself twice and I'm here to tell you about it. I drove myself to the doctor to have them done and I drove myself home as well, without any problems.

As for the MRI, PLEASE REMEMBER THAT I AM NOT A DOCTOR, OR ANY KIND OF MEDICAL PROFESSIONAL, JUST SOMEONE WITH EXPERIENCE AND SOME KNOWLEDGE OF SPINAL ISSUES.

BUT I can tell you a few basic things about the MRI.

Synovial cysts are fluid filled and benign and can develop in the facets of the spine from degeneration of the facets.
They may or may not cause pain, but if large enough the can press on nerves within the spine and cause pain.
The location of the pain would depend on where the cyst is and what nerve area they are pressing on.

In your friends case, it is pressing on the L5 area which would cause the leg pain and numbness in the legs.

It appears that the nerves are being compressed in the lateral recess area of the spine, which is an area that many spine surgeons do not bother with when they do surgery to decompress nerves and the patient ends up with no relief or only minimal relief from spinal decompression for the nerves.

The question would be to try and determine if the cyst is causing the decompression or it is narrowing of the foramen in the L5 vertebrae and what the best treatment would be.

It is true that sometimes spinal surgery creates more problems but no always, and sometimes it is the best solution for a person.

Unless the situation is a life threatening or dangerous to long term damage to nerves, a good spinal surgeon would first do the necessary tests to determine what the problem and make a diagnosis and then proceed with the most conservative treatment possible. Only, if that doesn't work, would surgery be discussed and a doctor would give his/her best opinion, the reasons for what he/she believes is the reason for surgery and then say something like, the ultimate decision is up to you.

I would strongly advise that your friend see either an orthopedic surgeon that specializes in spines only or a neurosurgeon that specializes in spines only and get several opinions before making any decisions on what to do surgically.

The MRI also mentions a type of scoliosis which is a curvature of the spine.

She says she is seeing a neurologist. I don't know if she really meant neurologist or a neurosurgeon.
If she is seeing a neurologist, then this type of doctor is not qualified to treat or diagnose her spinal issues.

Please get your friend to see a spine specialist and she really needs someone to go with her to these appointments so that someone else can hear what is being said.

Good luck and keep us posted.

Fran
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Users who thank littleonefb for this post: mominashoe 

replied January 31st, 2009
Patient with Synovial Cyst
I had a synovial cyst at the L4/5 level and had foot drop and extreme pain down my left leg. I ended up having surgery with an orthopedic back surgeon. I had a 2 week recovery period and then I was pain free. Worked hard to exercise the foot and strengthen it to eliminate foot drop. Surgery was a laminectomy to remove synovial cyst. It was outpatient surgery with about a 2 inch incision in my lower back.There did not appear to be any other option to remove the cyst.
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