Worse MRI results....what will happen next?

Posted by denman55 @denman55, Jan 23 6:52am

I just had a new Lumbar spine MRI and a (R) Hip MRI. I have been in total pain down my (R) leg since November. I thought I had Sciatica and Piriformis syndrome. I ended up getting (3) Steroid injections, 2 of them directly into the Piriformis muscle. But I got no relief from the pain. I can barely sit, stand or walk due to the pain.

My Lumbar spine MRI indicates L3-L4 moderate spinal canal narrowing and L5 impingement of the L5 nerve roots (which can cause the pain from the buttocks to the toes). It also shows severe left and moderate right foraminal narrowing L5-S1.

I don't know what will happen next with me, or which physician I should be seeing about all of this - Pain Management or Orthopedic Surgeon. Any ideas from anyone?

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Excellent. Wishing you the best as you gather information to weigh your action trade-offs. Happy to render my opinion as requested.

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@upstatephil

Excellent. Wishing you the best as you gather information to weigh your action trade-offs. Happy to render my opinion as requested.

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Thought I would just give you an update ----- So, I called the Neurosurgeon's office that my Physiatrist recommended --- the young lady who answered the call for "New Patients" proceeded to ask me a million questions and had me read to her the results of my MRI to her over the phone. She then proceeds to tell me that she will get the report from the Radiology practice and give all of the information to the Neurosurgeon who will review it all, and if he THINKS he can help me, they will call me back and make an appointment for me, but also wanted to let me know they are in this location (my town) one-day per month! It is not to be believed what is happening today in the medical field.

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Wow. We were willing to drive seven hours to get to the right facility and the right doc. Yes, it's inconvenient but boy, when messing with my spine, any inconvenience is worth getting the right answer and best outcomes.

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Never give up. Keep digging, scratching, researching, asking questions...all until you're satisfied.

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@denman55

Thought I would just give you an update ----- So, I called the Neurosurgeon's office that my Physiatrist recommended --- the young lady who answered the call for "New Patients" proceeded to ask me a million questions and had me read to her the results of my MRI to her over the phone. She then proceeds to tell me that she will get the report from the Radiology practice and give all of the information to the Neurosurgeon who will review it all, and if he THINKS he can help me, they will call me back and make an appointment for me, but also wanted to let me know they are in this location (my town) one-day per month! It is not to be believed what is happening today in the medical field.

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@denman55 This is common for the best spine surgeons to review records or imaging reports before accepting a patient as they are so scheduled that their available time is very limited. There are a lot of patients complaining of back pain that do not really have a spine condition that would require surgery. They do this to make sure that surgeon's time is matched to the right patients. It's not a personal judgement of you; it is just standard practice. You can also seek out other medical opinions if you choose. Surgeons do travel between offices and you are lucky to have one so close, but don't let that limit you to surgeons in your neck of the woods only. For me, it was worth it to drive 5 and a half hours to get to the right surgeon at Mayo. I fulfilled the same request before I got appointments from several of the surgeons I saw. To become a Mayo patient, I had to send in the reports and imaging on CDs for them to review. I don't think you will have trouble getting an appointment for a consultation. If not from this surgeon, from another. You may want to research other surgeons and try to figure out who the good ones are. I always had a plan B because my case confused 5 surgeons and they wouldn't help which is why I ended up at Mayo.

Jennifer

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@denman55

I see my spine physician on Friday - I don't know what type of "surgeon" he is considering referring me to. I've already had numerous Epidural steroid injections, Physical therapy, Acupuncture, Chiropractics, RAF, the MILD procedure, and also had the Sprint PNS System. Looks to me like I really have reached the end of my rope .....

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I agree 100% with upstate Phil! But will add be 100% certain you trust the person you will allow to invade your body.

Last night I returned from a 1,000+ mile (and very expensive) journey to consult with a neurosurgeon about the 4-level laminectomy I, reluctantly, agreed to last March.

I am worse than before the surgery and the 2nd neurosurgeon explained why... while showing me on the MRI images. I "knew" in my gut I shouldn't have done it, but when they start throwing around words like "emergency", "paralyzed", "permanent nerve damage to bladder and bowel", etc. I allowed myself to be talked into.

So, now the pain and weakness (similar to your description) that was primarily on the right before surgery is also on the left. I have fallen numerous times, the last time ending up in the ICU, intubation.

Have the neurosurgeon show you the MRI images and expression, in detail, why that is producing your issue and what he/she/they will do that will correct it.

BTW, the neurosurgeon I saw this week had done minimally invasive laminectomies 10 years ago successfully. My internet search failed me! The facility had closed and I couldn't recall his exact name until I dug up my old files. (I also have cervical issues, meds, and AIs that affect memory.)

Best of luck to you!

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The pain from sciatica, which is an umbrella term for many different things, can take anywhere from 6 weeks to many months to resolve. Numbness, tingling, instability, etc can take longer, come and go, and wax and wane.

If you're interested in some educational videos to help with questions to ask or to understand anything you might not understand in your consult, I highly recommend Brian Su, the Spine Guy, on YouTube, add anything by Tom Jesson, MD, who teaches physicians about lumbosacral spine problems.

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@debkl

The pain from sciatica, which is an umbrella term for many different things, can take anywhere from 6 weeks to many months to resolve. Numbness, tingling, instability, etc can take longer, come and go, and wax and wane.

If you're interested in some educational videos to help with questions to ask or to understand anything you might not understand in your consult, I highly recommend Brian Su, the Spine Guy, on YouTube, add anything by Tom Jesson, MD, who teaches physicians about lumbosacral spine problems.

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@debkl

The pain from sciatica, which is an umbrella term for many different things, can take anywhere from 6 weeks to many months to resolve. Numbness, tingling, instability, etc can take longer, come and go, and wax and wane.

If you're interested in some educational videos to help with questions to ask or to understand anything you might not understand in your consult, I highly recommend Brian Su, the Spine Guy, on YouTube, add anything by Tom Jesson, MD, who teaches physicians about lumbosacral spine problems.

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Thank you very much for your reply and recommendations. The main problem right now is that I had (2) MRI's done - Lumbar spine and (R) hip and the prescribing physician never bothered to review the results with me, and because their computer system was down he did not have an opportunity to view the discs. So, I have no idea what my problems may be, I only know my symptoms. I've been in pain since November. I have, what feels like Piriformis syndrome, and I have pain down my (R) thigh, extending down to my ankle which is constant. I don't know what's causing my pain, however it must be back related as my physician referred me to a Neurosurgeon. Now whether this Neurosurgeon will accept me as a patient after reading the reports and viewing the MRI's is up in the air.

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