Well it's been awhile..I was progressing really well and then a cascade of evil wicked things started happening. My husband came home from our Mayo trip with back pain. At first it was just uncomfortable and 3 Ibuprophen 4 times a day seemed to help. Then it continued to progress until he got to the point where I could tell he was in pain continuously. So I called the Orthopedic doctor and got him in for an appt.

They xrayed and declared it was minor arthritis. They started him on physical therapy which did nothing but make the pain worse. So he went back to the doctor and it was decided that he was suffering from bi-lateral sacroilliac joint pain. The doctor injected in the area of the sacroilliac joints both sides with a steroid. Two weeks later he was no better. At that point I said Enough! and called the ortho and insisted on an MRI. After getting the results of the MRI, the doctor called and told us that he wanted to refer him to a neurosurgeon in the Dallas area. Here is the MRI result:

1. Severe Spinal Stenosis at L4-L5 due to minimal diffuse annular disc buldge and severe facet hypertrophy and ligamentum flavum thickening. There is associated mild narrowing of the neural foramina bilaterally.

2. Minimal diffuse annular disc bulge at L2-L3, L3-L4, and L5-S1 with facet disease resulting in only mild foraminal narrowing bilaterally.

3. Multiple nerve root cysts throughout the lumbar spine and sacrum as an incidental finding.

4. Moderate schmorl's node superior endplate of L3.

The surgeon wants to do a mylogram first and then do surgery. He showed us the MRI. Even to an idiot the narrowing and spinal cord impingement was very obvious. His spinal cord is really good until you get down to L4-L5 and there it looks like someone put a rubber band around it and shrunk it down to a tiny passageway. It's almost totally blocked.

He's scheduled for the mylogram on the 26th and we go from there. Surgeon said he'd need to see the mylogram to know for sure, but he thought he could do a laminectomy in that area and not have to fuse. I'd sure like to have your thoughts on this.

As to my thoughts on this surgery..Shooooosh!! It knocked the air out of me. He's always been so healthy and so fit. He's 72 years old, all muscle, takes no meds and has no known medical problems other than this back issue that has just come up. He did tell me that he had some pain before the trip to Mayo but he just thought it'd go away and I guess with all the driving, lifting luggage, wheeling me around in the wheelchair etc. it kicked the pain into high gear.

Me, I was getting around a whole lot better and then last Thurs, my ankle started swelling. On Tues I got a steriod injection into the ankle joint and am still gimpy. I gave up last night and started using crutches because it was almost impossible to walk. Does bad luck come in 3's??!!

Thoughts on the surgery would sure be appreciated.

Billye

--both from your standpoint and his.

Given that he's 72, and apparently has always been active, it may just be a wonder that symptoms have held off this long. There's a saying that almost all of us who survive past middle age now outlive our spines--they just don't seem, evolutionarily at this point, to be able to handle all that upright bipedal pounding for that long a time.

Over 50% of people past age 50 have arthritic degeneration of the spine--most notably lumbar, but often cervical--but not all have symptoms. If he is the big stoic type, he may well have had symptoms of mild-to-moderate variety for a long time and ignored them, so as not to worry you and contribute to any more stress for you.

The real question here--and sure the spinal disorders people (and Liza Jane) will give all sorts of opinions--is to what extent the cord itself, and the cauda equina terminal extentions of the cord, are being impacted by the stenosis. This is generally looked upon as a more serious situation than impingement only of the nerve roots resulting in a radiculopathy. (One can have both, of course.) From what you posted, there seems to be fairly minimal foraminal narrowing (the foramen is where nerve roots are), and a lot of us have diffuse disc bulgers, but the severe facet hypertrophy and ligamentum flavum thickening seems to me the most arresting part of the report (that, and the nerve root cysts--something has been irritating something there for a while).

I would hope that a myelogram would confirm the idea of a laminectomy. How is he otherwise functionally? Is pain the basic symptom, or does he have other neural symptoms, or muscular/autonomic compromise? The latter would be more alarming and more likely to result in more extensive surgery.

Glenn, thanks for your opinion.

He's in pain and having to stoop forward to walk with the least pain. There is some weakness in the left leg. I'm not seeing any evidence of anything else. He's very healthy and as you can imagine, this is quite frustrating to him. His youngest son has bombarded us all day with medical abstracts of the different types of correction for a spinal stenosis. He and I are both really confused now as to what would be the best thing to do. It does seem quite complicated when you don't have any real way to know how competent the surgeon is.

He has been so athletic all of our life together that I'm not at all surprised to see all the nerve root cysts. I really believe that he doesn't feel pain like most people. We have the mylogram scheduled now and will have it in about a week so maybe we'll have a better idea of what is going on.

Liza Jane phoned me last night so I have her opinion on this now.

I really do appreciate all comments.

Billye

Hi Billye, your husbands report is very similar to my own cevical spine report, but i have a lesion in the spinal cord which is inoperable.

I had 5 physio therapist all up, they all reckon they could do wonders but they all failed miserably and really hurt me, they all aggravated my condition, this crap about use it or loose it, is all b......t

The only things that helped me were heat bags ,powerfull magnets, & a combination of lazor + old chinese accupunture. and being real carefull not to aggravate it which is a lot harder than it sounds.
I hope there is something else that can help other than an operation.

I am so sorry to read this.

I also don't have a clue about what should be done.

There is a pain doc on Chronic Pain at OBT. His name is Steve Lobel.

He offers opinions to people sometimes. You might post to him there with
the report findings.

If a management could be done without surgery... that would be my choice.

I'd also ask at Spinal forum over there.

My thoughts are with your husband and you, as always!

Hi there Billye:

Just wanted to send you hugs and wish you and your hubby well.

Alan has severe spinal stenosis as well. Right now, he is dropping off his spine MRI Films to a doctor at Methodist who will give a look and determine if Alan can be helped.

Since we've been to spinal surgeons before and no one said they could help, I have no idea why the neurologist thinks that THIS GUY will be different but she is very supportive of Alan finding out why he has PN and we do know he has severe spinal stenosis.

He is like your hubby in that he is very athletic (he goes to the gym minimum 3 times a week) sometimes more.He maintains his weight. He looks great, he just has the darn PN between the toes that drives him nuts at times.

So here's hoping your hubby gets some relief.

Oh, my husband had gone to a chiropractic/neurologist and if it wasn't for that man, my husband would not be in any kind of shape to go to any gym whatsoever. He weighed 267, he could not bend, could not lift his leg, COULD NOT DO ANYTHING. He went to Dr. Theirl and from that time onward, he got off the pain meds, opiates, all stuff and he did the exercises he was told to do. His PN improved dramatically from that time.

Different people have different symtpoms I gather.

Hope your guy gets relief.

Regards,
Melody

You know when you are going to the doc for a "check up" and you just have a feeling of "doom"? I've had some new "symptoms" today and over the 3 day weekend and I'm not feeling so confident. Going to the doc in about 15 minutes and just insecure feelings are running through my head.

I just got a feeling of "who would be there for my girls if something ever happened to me?" I lost my mom a few years ago, and my girls are just now in their early 20's. Who would be there for them if I weren't around? I have a half sister, but she is so self absorbed, my daughters already don't like her because they see right through her.

Their dad is currently divorcing his 3rd wife, (darn, she was a keeper too!) You know, you think about what material things you would leave your kids, but it really makes you think about who you would want to give them "life" advice if anything happened to you.

This is something I will be thinking about over the next few days. I don't know why it came into my head, but it's something I can't let go of until I figure it out!

Thanks for being my sounding board.

Terri