Help With Mri Results of Lower Back And F/u Opinion Posted: 08-18-07 01:05am
First I’ve had lower back pain off and
on for the past 5 years. A couple weeks
ago I awoke at 4am with severe pain in my
lower back, radiating down my left
buttock, left leg and foot. I went to the
E.R and was given an X-Ray. The E.R doc
said I had a bulging disk in my lower
back. The doc said “Everyone has a
bulging disk, just right now, yours is
really bulged”. I was given a shot of
tordol(sp), a couple valium right there. I
was also given a perscription for
oxycodone w/apap 5/325 and Diazepam 10mg
and told to follow up with the military
hospital. Since this day, the littler
toes on my left foot are numb, I have a
burning sensation on the left side of my
foot and back of my ankle. My left leg
feels “lighter” than my right leg and
just doesn’t seem to respond as fast .
The military Physicians Assistant(PA)
scheduled a lower back T/L MRI for me at
our local civilian hospital. 5 days later
the MRI was done. The radiologist report
states:
Findings: Composite images show some
straightening of the usual lordosis. There
is an anomalous L5-S1 level with
sacralization of the L5 vertebra. This
correlates with the plain-film acquisition
of 7/22/07 showing the small vistigal T12
ribs.
Vertebral body heights, appearance, and
signal are preserved, allowing for
multiple Schmorl’s node deformities seen
on the superior and inferior T12 endplate
and the inferior L2 endplate. These
generally are of no clinical
significance.
Vertebral body height, appearance, and
signal are preserved with no marrow edema,
hemorrhage, and/or edema.
Conus is seen at about the T12-L1 level
and shows no mass effect and/or abnormal
signal in this uncontrasted study.
Disk spaces demonstrate the L1-L2 level
and above to be essentially of normal
height, appearance, and signal without
herniation apparent.
The L2-L3 level is of normal height,
appearance, and signal.
The L3-L4 level demonstrates normal height
and signal without herniation of the disk
evident.
The L4-L5 level shows diminished height
and signal. There is a broad-based annular
bulge into the left anterolateral canal
and neural foramen consistent with L4
nerve root entrapment. A small fragment
extends inferiorly into the left lateral
recess, entrapping the thecal sac and L5
nerve root.
The L5-S1 level shows essentially no disk
material to be present.
Conclusion: L4-L5 disk herniation to the
left of midline with a fragment extending
into the left lateral recess.
After my MRI results came back, I was
referred to a military Orthopedic Surgeon
to discuss my options. Instead of the
surgeon, I met with a Physicians Assistant
that didn’t even read my medical records
and I had to practically force him to look
at the MRI results the civilian hospital
had put on a Computer Disk. While speaking
with the PA I was asked how long until I
was to retire from the Armed Services and
questions that I didn’t think had any
bearing on my current situation. The PA
mentioned that radiologists don’t really
know what they are looking at which left
me wondering why they even look at them to
begin with. He then left the room to
review my MRI images, then came back 15
minutes later . He said that the reason I
have numb toes and the other symptoms was
the disk material was pushing against my
nerve and “irritating it”, not really
compressing it. A friend of mine told me
that the longer a nerve is pinched there
was a less chance of me getting feeling
back. I asked the PA if this was true and
he stated that the numbness and pain would
never go away, and I’d hopefully just
“get used to it” and even if they did
operate on me, it wouldn’t stop the
numbness and burning sensations in my foot
and leg. We would have to take a “ wait
and see” approach and was told to come
back in 6 weeks. I was prescribed motrin,
steriod injections in my lower back and
physical therapy. No prolonged standing,
sitting, running for 2 weeks.
My gut feeling is, I should get a
second opinion. I just wanted to throw
this out there and see what any of you
have to say. I apologize for the long
post, I am in pain, feeling hopeless at
the moment and would like to see what
others might have to say.
Thank you for your assistance.
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yogahoneybunny
Supporter
Joined: 04 Jan 2006 Posts: 880 Location: Strumica, Macedonia
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Posted: 08-21-07 11:06am
If nothing else, a second opinion from a
caring doctor may actually provide you
with some compassion! Yes...I say go for
it! Better to explore all options and
make an educated decision.
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sillyakchick
Moderator
Joined: 12 Apr 2007 Posts: 2690
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Posted: 08-30-07 13:14pm
Get a second opinion. If there is a free
fragment in there, it really needs to be
removed. the fact that you have numbness
and burning in your left foot and you have
nerve root entrapment is a really
significant finding. i am sorry about the
shoddy treatment you received. I don't
necessarily think surgery is the best
thing for most people, but I think in your
case, you need to get that fragment out of
there stat. It is not only causing your
pain, it could do some long-term damage.
you could try the steroid injections, but
the fragment is what worries me. Best of
luck.
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subliminll
New User, Becoming EHEALTHy
Joined: 17 Aug 2007 Posts: 3 Location: California
Posted: 08-30-07 19:08pm
Thanks for the info! I did set up an
appointment for a second opinion and was
told it would be a "Real Doctor". I ended
up seeing another PA that said he felt
comfortable with the earlier
recommendation. He mentioned that the
numbness and pain in my foot may go away
with physical therapy. (Not sure i believe
this but i guess i want to).
I had my first round of Physical
Therapy yesterday and while my back was
starting to feel better (before physical
therapy), It isn't now. The pain / burning
in my left foot seems to be mainly along
the side and bottom left side. The left 2
toes are still numb and left leg still
seems weaker than the other. This was
noticed by the Physical Therapist.
I called a couple spinal doctors in
town for a consult / second opinion, and
they seem to have a 3 month waiting list
to see patients.
I appreciate the feedback and will
keep you updated as I find anything out.
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sillyakchick
Moderator
Joined: 12 Apr 2007 Posts: 2690
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Posted: 08-31-07 09:53am
OH that is really a long time to wait.
Did you tell them you had a fragment?
That may get their ears pricked up a
little bit.
We can seee you next Tuesday if you would
like to drive about 1600 miles.
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rollar64
Experienced User , Rather EHEALTHy
Joined: 21 Nov 2006 Posts: 143 Location: melbourne
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Posted: 09-04-07 04:26am
Hi Subliminal sacralization is described
as A developmental abnormality in which
the first sacral vertebra becomes fused
with the fifth lumbar vertebra this can
be a serious condition you need to have
an honest talk with a medical professional
who knows something about this. You seem
to be getting the usual routine which is
to tell the patient as little as possible.
Good luck.
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subliminll
New User, Becoming EHEALTHy
Joined: 17 Aug 2007 Posts: 3 Location: California
Posted: 09-04-07 13:07pm
Thank you again for your responses. I have
a follow-up appointment with the PA in a
couple weeks and will deffinately ask
about these things.