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DiscussionHow many times is epidural given before surgery is considered?
Spine Health | Last Active: Jul 26, 2021 | Replies (13)Comment receiving replies
@tacitsentinel I'm sorry you are going through these spine issues. I am a Mayo spine surgery patient and I wanted to make you aware of some things in your post that caught my attention.
Because you had resolution of your bladder/bowel issues with a spinal epidural injection, those should be investigated as possibly being spine related. Those issues can be caused by cervical spinal cord compression. If you have not had MRI imaging of your complete spine, you wouldn't be able to rule that out as a secondary problem or know if it is related to your recent injury. The injection works by reducing inflammation and takes pressure off the injured area temporarily, and this can be considered as a diagnostic procedure. I did have issues emptying my bladder because of cervical spinal cord compression at C5/C6. You could also have spinal cord compression at the lower end of your spine too. The symptoms of cord compression are harder to pin point because when the whole spinal cord is compressed, you don't know specifically what part of it is affected. The dermatome map is very specific for nerve issues that arise from the nerve roots between the vertebrae. When you have a collapsing disc, that space between the vertebrae (the foramen) gets smaller and if is is also affected by inflammation, extruded disc material or bony growth, the space where the nerves exit gets compromised and can press on a nerve passing through the space.
I also had leg pain, and pain all over my body caused by cord compression in my neck. This is referred pain that is known as “funicular pain”. Here are links to medical literature and cases of funicular pain.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111492/
https://neupsykey.com/neurologic-evaluation-of-the-cervical-spine/
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03299-x
https://www.hopkinsmedicine.org/health/conditions-and-diseases/myelopathy
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03299-x
This is an excerpt of a Spine Health link that explains "funicular pain".
“Funicular pain is another type of spinal cord-related pain and may occur when the cord’s ascending tracts—the spinothalmic or posterior column tracts—become compressed or irritated. Funicular pain tends to present as an achy, throbbing, or cold feeling in one of the limbs, such as a leg, or in the trunk of the body. It can also feel electric shock-like and similar to radicular pain (sciatica) going down the leg. Sometimes funicular pain is experienced when the neck is flexed forward, known as Lhermitte’s phenomenon, and results in a searing pain that can travel down the spine and/or into the arms or legs.4”
https://www.spine-health.com/conditions/neck-pain/types-neck-pain
That was my experience too and it was missed by 5 surgeons who evaluated me, and none would help because they didn't understand the problem or why I has all these crazy seemingly “unrelated” symptoms. You should share this with your attorney and get another opinion with a surgeon who understands funicular pain. You can't trust medical opinions that were selected and paid for by your employer because they were hired to discredit you. You don't have to keep doing spine injections. They will not solve the problem and often are used to postpone potential surgery. Injecting steroids into the spine is not FDA approved, although many doctors do this.
The leg pain you are having can be spine related. It isn't always a nerve problem in the legs and compression anywhere along the nerve path from the spine to the leg can produce the symptoms.
I also wanted to mention the light headedness you described. That can be caused by a cervical spine problem. I did experience dizziness and vertigo when I had muscle spasms before my spine surgery. I had spinal cord compression at C5/C6 and spams that twisted or tilted the vertebrae and caused dizziness and headaches. There are arteries that pass through the sides of the cervical vertebrae on their way to the brain, and if you stretch these or kink them when vertebrae get twisted or tilted and it stays that way, it alters the blood flow to the brain. The spasms also effectively made the spinal canal smaller om my compressed spinal cord and caused issues with an uneven gait and difficulty emptying my bladder.
Since your case is complicated by the referred pain, you need a surgeon who understands funicular pain. I suggest using the medical literature and saying you think your case might be like this and ask the doctor. You will find out if they understand it by dong this. A spinal deformity expert would be a good expert for another opinion. You should search for the best surgeon you can find right now for another opinion so you will be ready with a good surgeon on your case if you proceed to surgery. Don't just settle for one opinion because it took so long to get there. It's a big decision and there may be different surgical approaches and you would need to understand your choices.
I did have a spinal deformity neurosurgery expert for my surgeon who was also trained in orthopedic spine. If you have any instability or slipping of vertebrae over each other at your injured lumbar area, you would need this type of surgeon. Here is a patient story like that from my surgeon and also my story. Let me know if I can offer more assistance, and please check back so we know how you are doing.
https://sharing.mayoclinic.org/2017/07/26/spinal-surgery-saves-teen-swimmers-mobility/
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/
Replies to "@tacitsentinel I'm sorry you are going through these spine issues. I am a Mayo spine surgery..."
I wish I could get into mayo clinic. I tried but they would not let me come. Shattered my L4 3 yrs ago and have had neck fusion about 6 yrs before that. Neck is going bad now and back and leg pain. Bladder problems. Saw a new ortho Dr. He said he wouldn't touch my back now to muck wrong. Only way to treat pain is through injections. Epidural steroid, Si joint, and My RF'S.