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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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Mentor
Jennifer, Volunteer Mentor | @jenniferhunter | Mar 5 2:03pm
In reply to @lcl44 "Thank you, too, for your advice. I’m trying to not get ahead of myself with this,..." + (show)
@lcl44

Thank you, too, for your advice. I’m trying to not get ahead of myself with this, as sadly I often do. Let’s just see what this surgeon says first, one part of me is telling the other! I found this interesting to read.
https://www.spine-health.com/treatment/spine-specialists/how-select-a-spine-surgeon
You risk(1) is exactly what I am worried about w.r.t the cauda equina nerve issue. I intend to ask what is the usual timeline for how this condition develops. Is it gradual or might something precipitate an emergency situation (E.g. loss of bladder/bowel function)?
Since my husband was reluctant to even try injections, you can imagine his enthusiasm for surgery after he has gone through bypass surgery, unblocking femoral artery, and removal of part of his pancreas .. just to name the main ones. He is a lot better at not trying to predict the future than I am! 😉

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@lcl44 I have looked at spine-health.com too for information. If you look at the red flags they mention, those are good things to keep in mind. There should never be any pressure to do surgery, and your questions should be answered willingly, and they should not be offended if you seek other opinions. This is normal and good for the decision making process.

Jennifer

REPLY
lcl44 | @lcl44 | Mar 5 3:19pm

Thank you, @jenniferhunter and the others that have responded. We saw the surgeon today and he was very open to explaining everything and answering questions, including mine about his board eligibility vs. Certification. 😉
All three of us coming from England might have helped the conversation.
We are going to ponder surgery, which would be laminectomy, at this time because:
1) husband’s A1C is a slightly higher than surgeon’s cut-off for surgery
2) surgeon suggested giving injection a try while we try to lower A1C, to see if it provides relief.
And we have time to discuss more with our PCP re: getting further opinions.
Many Thanks, and my good wishes to those who are struggling.

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