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EMG Results and Epirdural Shot question
Spine Health | Last Active: Aug 22, 2023 | Replies (41)Comment receiving replies
Hello @jenniferhunter Yes, i have seen 3 surgeons, two orthopedics and one neurosurgeon, one orthopedic believes my issues are coming from my neck due to a disc herniated 4 mm, but the neuro and 2nd ortho said no surgeries is needed, as they don't see how surgery would fix anything they see on my MRIs, the ortho said it could be Piriformis syndrome but did not confirm 🙁 the neurosurgeon said, go do the epidurals and if the pain continues we can see what we can do to alleviate the inflammation there, so again, are you saying yes or no on surgery, i don't know he wasn't clear.
None of the doctors the 3 surgeons, muscular neurologist, or pain management have been able to explain polyradiculopathy cause, but like neuro said, most be coming from S1 L4 and L5 based on the EMG findings.
I'm very confused with the MRI as i read there is a Herniated disc (see below) but the doctors are not paying much attention to it, this is my 2nd MRI:
"L3-L4: Disc height loss is seen with a diffuse annular disc bulge which impinges upon the ventral surface of the thecal sac and is superimposed upon facet hypertrophy. Mild spinal canal stenosis is seen. There is mild to moderate bilateral neural foraminal stenosis identified.
"L4-L5: A broad-based central disc protrusion type hemiation impinges upon the ventral surface of the thecal sac.
The spinal canal is patent. Moderate bilateral neural foraminal stenosis is seen.
"L5-S1: A broad-based central disc protrusion type hemiation remains subligamentous. The spinal canal is patent.
Mild to moderate bilateral neural foraminal stenosis is seen"
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@soccer1477 My case was also really confusing to the surgeons, 5 of them before I came to Mayo. I did have one spinal epidural injection done as a diagnostic in my neck, and it relieved all my pain everywhere, legs included temporarily. The surgeon at the time didn't understand why that could be, so he dismissed the results. This is because he didn't understand the funicular pain phenomenon that caused pain all over my body and it was generated in my neck by stenosis with a disc osteophyte complex that was pressing 5 mm into the spinal canal causing a bit of spinal cord compression. I hear many patients talking of similar situations in having leg pain with a cervical stenosis problem and their surgeons don't know what's wrong. If surgeons can't pin point and understand the cause of the problem, they are unlikely to help. You are getting varied opinions and I did too. They have to look for the differential diagnosis of what else could be wrong because they can't afford to be wrong and make a mistake with surgery.
If you try an epidural injection, it may give you more information, but only you can make that call. Having an epidural in my neck that also helped leg pain was a predictor of funicular pain, but there is no diagnostic test to prove the existence of funicular pain except when decompression surgery fixes it. You also have stenosis at the nerve roots, so that confuses where the pain is coming from. It can come from both places or either of them, the nerve roots or the spinal cord if it is getting touched or compressed.
The Piriformis Syndrome also mimicks a spine problem because of creating similar pain. You may want to read about these kinds of problems at this link:
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
Jennifer