I have severe spinal stenosis. Inflammatory arthritis along with osteoarthritis are both contributing to my problems with my lumbar spine. The inflammation associated with PMR doesn't help the situation.

I was taking Actemra for PMR and doing well until the Covid epidemic happened. Supplies of Actemra were diverted to seriously ill Covid patients. I was okay with that because hospitalized patients with Covid had a greater need for Actemra than I did.

During the time I was off Actemra my overall condition deteriorated. I needed prednisone again since I was unable to take Actemra. My PMR symptoms were returning but it was a combination of things that made my spine worse. The biggest concern was the formation of a synovial cyst on my lumbar spine. The spine surgeon said paralysis was a distinct possibility if I didn't have surgery. There wasn't enough space in my spinal canal for a synovial cyst.

The MRI of my spine when I was off Actemra but taking prednisone said the following:

"L4-L5: Broad-based disc herniation with pronounced bilateral facet degenerative changes and severe right greater than left foraminal narrowing. There is a synovial cyst arising off the medial aspect of the left facet joint and compression of the right exiting nerve root.

Combination findings with severe central spinal canal stenosis at this level with foraminal narrowing."
https://my.clevelandclinic.org/health/diseases/24856-foraminal-stenosis
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My symptoms improved when the supplies of Actemra improved. I was able to discontinue prednisone after Actemra was restarted.

My MRI after I was back on Actemra said the following:

"Multilevel degenerative disc disease of the lumbar spine with severe central canal stenosis.. The synovial cyst at L4-L5 has decreased in size since March 2022 and is now barely measurable. Regardless, there is still severe canal narrowing at this level."

Since all of my symptoms improved, the spine surgeon said surgery could be postponed saying there was more space available in my spinal canal and less foraminal narrowing.