[billygee]

Saw my primary doctor yesterday and she was kind in of to print this for me.Also she said there was a note in my file that i may have to have another nerve/muscle biopsy done.I had one done last year and the samples are to small.Thanks in advance.

Work Copy Only"
Comparison-1/18/2012. Findings: There is a mild levo curvature.Mild endplate compression of the lumbar vertebral bodies is grossly unchanged.Marrow signal is within normal limits, other than end plate degenerative changes,for the patients age. The visualized spinal cord is within normal limits.The conus ends at T12-L1.
Moderate degenerative changes of the disc spaces seen in the mid and lower thoratic disc space.Moderate to servere disc space and facet joint degenerative changes seen at L2-L3, L3-L4.Moderate degenerative changes seen on the rest of the lumbar disc spaces.There has been no significant interval change in the lumbar spine from 1/18/12. In the thoracic disc spaces, mild to moderate endplate degenerative changes seen.Prominent bridging anterior osteophytes seen in the mild and lower thoracic verterbral bodies. At right T2-T3, there is a prominent facet arthropathy with mild encroachment of the right posterior aspect of central canal.No other areas of significant cetral canal narrowing seen.
L1-L2: Prominent disc bulging and moderate facet arthropathy seen.Moderate servere central canal stenosis.Mild right foraminal narrowing seen.L2-L3: Marked end plate degenerative changes present.Moderate disc bulging present.Right paracentral disc protrusion has increased from the previous exam.Moderate bilateral facet arthropathy.Moderate disc bulging and facet arthropathy.Moderate central canal stenosis.Mild bilateral foraminal narrowing.L4-L5:Moderate endplate degenerative changes.Moderate disc bulging with broad based left paracentral disc protrusion.Prominent bilateral facet arthropathy.Moderate severe central canal stenosis.Moderate bilateral foraminal stenosis.L5-S1: Moderate disc bulging and facet arthropathy.No significant stenosis.Moderate degenerative changes of the disc spaces in the mid and lower thoracic disc spaces.Moderate to servere disc space and facet joint degenerative changes seen in the lubar disc spaces.There has been a slight change in the lumbar spine from 1/18/12. At L-2-L3, increased moderate server central canal encroachment seen due to slightly increased disc bulging and right paracentral disc protrusion.The rest of the lumbar disc spaces demonstrate persistent moderate severe central canal encroachment at L1-L2, L3-L-4, at L4-L5 as detailed above. No significant spinal canal narrowing in the thoracic disc spaces. Primary Diagnosit Code: Minor Abnormality.

[billygee]

Any thoughts

[Leesa]

I'll try to help Billy:

There are degenerative changes in the disc spaces in the mid and lower thoracic areas. This means that the discs are "flattening" and the vertebra are getting closer together, and since it's degenerative, its going to get worse.

There is moderate to SEVERE disc space and facet joint degenerative changes at L2-3 and L3-4. The facets are the 'wing-like' structures on each side of the spinal cord. If you hunch your back, you can feel them & even see them. There are moderate degenerative changes on the rest of the lumbar disc spaces. This means that all of the lumbar discs are flattening and the vertebra are all getting closer together. There are prominent bone spurs in the mid and lower thoracic vertebra. At the right T2-T3, there is prominent diseased facet with mild encroachment of the right rear of the spinal canal. This means that the facet is pushing on the rear of the spinal canal.

At L1-2 There is a prominent disc bulge and moderate facet disease. There is moderate to severe central canal stenosis. This means that the central spinal canal is getting narrow. Mild right foraminal narrowing is seen at L2-3 -- the foramen are the holes that the nerves pass thru to get to the spinal cord. At L2-3, the holes are narrowing. I'm not sure what the "end plate" degenerative changes means. There is a moderate disc bulge along with a right paracentral disc herniation which has increased from previous exam. There is moderate bilateral facet disease. Moderate central canal stenosis & mild bilateral foraminal narrowing.

L4-5 Moderate disc bulging with broad based with left paracentral disc herniation. Prominent bilateral facet disease. Moderate to severe central canal stenosis (narrowing of the canal) and moderate bilateral foraminal stenosis (narrowing of the foramen)

L5-S1 Moderate disc bulging & facet disease. Moderate degenerative changes of the disc spaces. (Again, the discs are flattening & the vertebra are getting closer together)


From the "Impression" the radiologist says that most of the trouble is the "persistent" encroachment in the lumbar spine, causing spinal canal stenosis. Since this is degenerative, it's not going to get any better and will probably get worse. I would take my films and get an opinion from at LEAST 3 NEUROSURGEONS, and see what they think should be done. You want to stay as CONSERVATIVE as you possibly can. Do NOT jump into surgery, as that should be your LAST RESORT. Surgery will NOT relieve all your pain. Surgery is ONLY for mechanical problems. After surgery, you will still have pain, and sometimes worse than before surgery. So make sure you have at least 3 opinions before opting for surgery as once you do it, you can't "undo" it. I wish you the very best Billy and please let us know what you decide. God bless and take care. If you have any more questions, let us know. Hugs, Lee

[ginnie]

I can only add, please get a few more opinions. Also keep a pain journal of just what is going on and bring that with you. Retain a copy of your records when you go doctor to doctor. If you can bring another person along to your appts. it will make keeping track of what is said easier. If you forget something your doctor says, the other person may be able to help. When you are upset, the mind kind of gets numb sometimes. I really hope this has good resolution for you. I will keep you in my toughts and prayers. ginnie

[billygee]

Leesa, A hugh Thank You for breaking down the results for me.I have a follow up on 3/8 and what i know so far is the issues i have in my back may not be causing my foot drop and i may have to have another nerve & muscle biospy.I had one done last yr and the samples where to small and maybe another emg.Iv'e been seeing a neurosurgen for the past 1- 1/2 yr as far as surgery we talked about it and wasn't recommended for the reasons you mention and he recommended me to see a differant neurologist in hopes that she can figure whats going on. I'll know more on the 8th to see what there thinking

[Leesa]

Billy it COULD be causing your foot drop. I'm not saying it IS, but it could be. You've got some SEVERE stenosis in places, plus some SEVERE disc space narrowing in places too. So there ARE issues that could be causing foot drop.

A Neurosurgeon could tell you for sure. But don't think that this ISN'T causing the foot drop because it very well could be. Make SURE that you ask about it, okay?

Also, make sure you take the most conservative option you can as far as what they intend to do. Let us know what the doctors say, will you Billy? I'd really like to know. Take care & God bless. Hugs, Lee

[billygee]

Leesa, i know i have issue's in my back and it's worse than i thought and i think it might be the cause of the drop foot, but the neurosurgen i was dealing with last yr thinks thinks other.I'm seeing a new neurologist and i believe they think theres something else going on thats causing my drop foot which i have in both feet. I guess i'll see what they say next month.I know i was given a heads up that they may want another nerve/muscle biopsy done.

[thinkitdoit7]

I just had my first neurosurgeon visit and was told that my foot drop and other leg issues were from my cervical (neck) not my lumbar (lower) spine issues.

I have all the stuff you listed in your MRI - lumbar severe canal stenosis, severe endplate degenerative changes, bone spurs and fused vertebraes etc.

I was surprised that the neurosurgeon was greatly concerned about the neck issues because for years I had MRIs of only the lumbar spine - never the cervical spine until last year. It showed cervical myelopathy and severe canal stenosis and much more.

The neurosurgeon said the spinal cord goes from your neck down to about T12-L1 and that spascity and numbness and foot drop usually is from issues above L1-L2, usually the neck.

Did you ever have MRIs of your neck? Might be what is causing your foot drop.

I was so sure that my leg and foot problems were from my lumbar spine never even thought about my neck.

So you might want to ask your doctor about whether or not your neck could be causing problems. I don't have any neck pain but I am glad my doctor ordered the MRI....

Keep us posted on your progress.

Kelli

[Leesa]

Kelly, you may have misunderstood, cause the spinal cord goes down to the BUTT. It's probably down to S1-S2 or so. I'm not sure, as the photo didn't have the numbers of the discs. But it surely is farther than L-1.

Just thought I'd mention that. You can look it up yourself. Just "google" spinal cord, and you can bring up all sorts of things. Plus it will show you pictures of spinal cords on alot of sites.

God bless and take care. Hugs, Lee

[billygee]

Originally Posted by thinkitdoit7

I just had my first neurosurgeon visit and was told that my foot drop and other leg issues were from my cervical (neck) not my lumbar (lower) spine issues.

I have all the stuff you listed in your MRI - lumbar severe canal stenosis, severe endplate degenerative changes, bone spurs and fused vertebraes etc.

I was surprised that the neurosurgeon was greatly concerned about the neck issues because for years I had MRIs of only the lumbar spine - never the cervical spine until last year. It showed cervical myelopathy and severe canal stenosis and much more.

The neurosurgeon said the spinal cord goes from your neck down to about T12-L1 and that spascity and numbness and foot drop usually is from issues above L1-L2, usually the neck.

Did you ever have MRIs of your neck? Might be what is causing your foot drop.

I was so sure that my leg and foot problems were from my lumbar spine never even thought about my neck.

So you might want to ask your doctor about whether or not your neck could be causing problems. I don't have any neck pain but I am glad my doctor ordered the MRI....

Keep us posted on your progress.

Kelli

Good question, I had asked that same question last yr becuasei had a disc ruptured and removed in my neck about 12yr ago.I beleive a nerve may have been pinched during surgery.C-6 i think.It was a bad rupture had to have emergency surgery.I had a ct scan done last yr and looked good other than the canal was narrow..Upper body is fine its just the legs and feet and of course my balance.I have a problem with both motor/sensory.Check out my posts.I've posted the emg & blood test results.