Got my MRI Film/Report

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misterkatamari
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Date Joined Jan 2011
Total Posts : 374
   Posted 2/14/2011 2:48 PM (GMT -6)   
I went up to the hospital today and got my MRI report and film to take with me to the Orthopedic surgeon on Wednesday. I plan to ask the doctor a lot of things, such as the relationship between my other back problems and my herniated disc. This is what the report actually says:

Comparison: MRI of the lumbar spine from 11/8/2007 demonstrating scoliosis, degenerative facet disease at L5 and S1 levels and L4-5 Levels. Remaining spine normal.

Findings: L1-2 Disc is herniated posteriorly and to the left, herniation is approx. 1 cm in size, this is markedly narrowing the left L1-2 foramen and impinging the left L1 root. Remaining discs of lumbar spine are free of herniation. T12 and T11 are free of herniation. Neural foramen are of normal size at remaining levels and nerve roots exit freely without evidence of impingement. Right L1-2 foramen is normal and right L1 root exits without impingement. Scoliosis is present with concavity to the right.

Impression: Since previous exam of 2007 posterior left herniation at L1-2 disc with narrowing of left foramen and impingement of left L1 root.

So, I don't know what all that means...which is why I'm going to a doctor obviously. I'm not even sure what degenerative facet disease is. My regular doctor said it was DDD, is that the same thing, or is facet different from disc? I read somewhere that facet disease can cause herniation and such, so I wonder if that means I'm at risk for it happening again. Hopefully I find out on Wednesday, and I really hope they look at any and all causes of pain and dysfunction so I have a better idea of how this all ties in.

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 2/14/2011 3:38 PM (GMT -6)   
 
     Hey Mister! smilewinkgrin
 
          Probably the best thing you can do is ask your surgeon all of these questions. One thing that I might suggest is that if this leads to surgery, many of the members here would recommend a Neuro Surgeon, instead of an Orthopedic Surgeon for spinal surgery. Here is a website that maybe a good source of information for you.
 
 
It also has some good videos on how to read your MRI scans.
 
   SE wink

Post Edited (Screaming Eagle) : 2/14/2011 1:53:28 PM (GMT-7)


Chartreux
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Date Joined Aug 2006
Total Posts : 9664
   Posted 2/14/2011 4:08 PM (GMT -6)   
Make sure to start a list of questions and make sure to take
it with you to this appointment, don't forget whatever this doctor says, please
consider getting a second opinion. Hope you can get a low pain day soon.
((((((((((((((((((((((((((((((misterkatamari))))))))))))))))))))))))))))))))))))))))))))))
prayers, well wishes and healing Hugz
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 2/14/2011 5:02 PM (GMT -6)   
Thanks!

I plan to ask him lots of questions. If he wants me to have surgery, I intend to get a second opinion. Although I'm not actually sure how you go about doing that. Do I ask him if I want one, or do I tell my PCP?

mrsm123
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Date Joined Dec 2007
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   Posted 2/14/2011 9:15 PM (GMT -6)   
DDD is also called degenerative disc disease, which is a misnomer. Anyone who is older than 21 is going to have some drying out of the discs between the vertebre.
It can be perfectly normal, and in others it may cause some pain depending on the amount of drying out of the discs.
The facet is the joint on the back of the vertebre where it joins the vertebre. It usually means arthritis of the facet joint and it can be painful in some people. http://www.eorthopod.com/eorthopodV2/index.php?id=79791a8f7dd9f446b38653cbeab9a955&disp_type=topic_detail&area=5&topic_id=182b99328f582f9da1335f674627ccc4
They usually offer injections of prednisone type medications, along with lidocaine type meds to numb the joint to see if that helps. If it does, they might offer a rhizotomy to burn the nerve endings.
The bigger concern that I see is the herniation that is compressing the nerve root on the left side. For that , they may offer a discectomy to see if that resolves the herniation enough to free the compression of the nerve root.
I don't know much about scoloisis and the degree of curvature so I won't be much help there, but I know that Dani has some knowledge there so she may be able to offer some advice.
Sandi M

straydog
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Date Joined Feb 2003
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   Posted 2/14/2011 11:50 PM (GMT -6)   
You will want your PCP make the referral for a 2nd opinion.
Moderator Chronic Pain Forum

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 2/15/2011 12:38 AM (GMT -6)   
Thanks everyone.

The MRI report does not seem to mention anything in regards to degenerative discs, just 'degenerative facet disease'. I just read some on it and apparently they are not the same thing, so I'm not sure why my PCP would have said that the report mentioned disc disease.

I've been told in the past that the scoliosis itself is mild to moderate. Nothing to operate on or fuse or anything of that nature. My PCP did say that I have rotation with the scoliosis as well, which he said is what causes some of my pain.

So yeah, the main reason I'm seeing the Ortho surgeon Wednesday is this herniation. So I'll see then what he wants me to do and what he thinks about it all. I do think I should mention all the other issues though.

Scarred_for_life
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Date Joined Jul 2008
Total Posts : 1560
   Posted 2/15/2011 3:46 AM (GMT -6)   
Mister;

I wanted to first say hi and welcome to HW. L1 and L2 are the upper part of your lumbar spine. Please get a second opinion if the Ortho wants to operate! I would suggest a well known neuro in your area that has knowledge of this kind of problem. Being a lower lumbar fusion patient (S1 through L3 altogther) I know what it is like to have to go through this. I was one of those failed back syndrome patients so I know what it is like to have all these percentages of failure thrown at ya and have the desperation that one has from this. I would also suggest reading up on your problem so that you are aware of every last thing that this entails.

With mine, I had surgery for the first in 2000 (S1-L5 and L4-L5) and back then the failure rate was 3% or at least that is what my neuro said. Now I believe it is up to 10%. I had one of the best neuro's in the state working on me and we tried everything before surgery with no relief. Now 10 years later (almost 11) I have one bulging disc at L2-L3 and there isn't a neuro that will touch my back even if it was symptomatic. Because my failure rate has now gone from the standard 10% to a whopping 80%. Talked to 4 neuros to get that percentage. Of course, I am not having symptoms for that area all mine are in the first surgery area L4-L5.

Hope this helped

Scarred
I live to "Tame My Pain!" 

bsjaguar
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Date Joined Jun 2009
Total Posts : 974
   Posted 2/15/2011 7:11 AM (GMT -6)   
Mister, I too have what the dr's call facet syndrome. The facet are joints which are attached to the vertebrae to stabilize the spine. When you develop ddd this narrows the disc space between the vertebrae allowing the facet to rub together. This rubbing effect causes the cartilege on the facet to wear away allowing osteophytes or bone spurs to develop. These bone spurs can cause havoc on the nerves which run between them. I ended up having radiofrequency ablation, where they use heat to deaden the nerve, and this did help. It is not a cure but if it is successful you may see 6-18 months of relief. You will probably need to see a good pain management doctor for this. It has been almost a year since mine and I am seeing some of the symptoms returning and will probably be calling to schedule another soon.

Does the disc herniation cause you problems? I'm like scarred, I had lumbar & cervical fusion and have had pain in both areas ever since but before the fusion I was becoming an invalid and had no other choice. If you haven't tried any of the non-invasive procedures yet I would recommend trying ultrasound, steroid injections or other procedures first.

I'm not a doctor but this is the way I understand the facet joints. There is alot of information on the net if you google facet syndrome.
---Jag---
 
DDD, osteoarthritis, facet syndrome, fusion surgeries C-5/7 & L-4/5 both in 2006, torn meniscus surgeries left knee 2000 & 2002, buldging disc L-2/3, fibromyalgia, polymyalgia rheumatica

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 2/15/2011 10:40 AM (GMT -6)   
misterkatamari,

As you explore your options, take seriously the idea of starting with the least invasive procedures first, rather than moving straight to discectomies, corrective rods, etc..

So, first look into epidural and facet injections then nerve ablations, etc..

Also, as you've asked about and others have suggested, get second opinions. In a previous post I listed a web site where you can find scoliosis specialists. If there's one in your area, do some more research on him/her such as via ratemds.com. If you find someone you like, you can ask your PCP for a referral or, if your insurance allows, you can directly contact the specialist for an appointment.

You might also try posting some of your questions on: http://www.scoliosis.org/forum/
They are not as active a group as the members here, but you may get further help with some of your scoliosis-specific questions
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 2/15/2011 7:23 PM (GMT -6)   
bsjaguar said...

Does the disc herniation cause you problems? I'm like scarred, I had lumbar & cervical fusion and have had pain in both areas ever since but before the fusion I was becoming an invalid and had no other choice. If you haven't tried any of the non-invasive procedures yet I would recommend trying ultrasound, steroid injections or other procedures first.
.


Thanks for the information. The disc herniation seems to have began when I first had this sudden onset of severe pain, so it seems that it could be the reason behind it. However, my PCP acts like the pain I am describing would not be caused by the L1-2 herniation, but that it sounds like it is much lower and would be something like L5-S1. L4-5 and L5-S1 is exactly where the MRI report indicates facet disease, and when I looked up information on facet disease syndrome the pain symptoms seemed to fit what is going on with me. So I want to bring up everything the report said. I feel like if I focus too much on 'I need surgery for the herniated disc' I may end up not getting full treatment. I don't want to jump the gun when something else may be the cause, so I'm gonna bring this all up.

Tomorrow's the big 'day'. Speaking of which, this is my first consultation with the surgeon. Do you see the surgeon again before any operation he suggests, or do you usually only have the initial consult and then whatever operation?

Based upon so many people's input on here, I think I may get a second opinion from a neurosurgeon. This doctor I am seeing seems to be the right match in terms of qualifications. He specializes in spine surgery and completed two spine fellowships--so it isn't like he just works on people's knees and dabbles with spines on the side. But qualifications don't mean his opinion is infallible, so if he suggests surgery I intend to get another opinion.

bsjaguar
Veteran Member


Date Joined Jun 2009
Total Posts : 974
   Posted 2/16/2011 6:53 AM (GMT -6)   
If the doctor says surgery right off the bat I'd definately be a little leary. Another thing to consider is that alot of insurance companies won't cover surgery until other less invasive & cheaper procedures have been tried first.

Believe me the facet syndrome causes alot of pain, mine moves across my lower back L-4/5 & L-5/S-1 into my hips. It is relentless and is only stopped by lying down. Good Luck and let us know what the doctor has to say.
---Jag---
 
DDD, osteoarthritis, facet syndrome, fusion surgeries C-5/7 & L-4/5 both in 2006, torn meniscus surgeries left knee 2000 & 2002, buldging disc L-2/3, fibromyalgia, polymyalgia rheumatica

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 2/16/2011 3:36 PM (GMT -6)   
bsjaguar said...
If the doctor says surgery right off the bat I'd definately be a little leary. Another thing to consider is that alot of insurance companies won't cover surgery until other less invasive & cheaper procedures have been tried first.

Believe me the facet syndrome causes alot of pain, mine moves across my lower back L-4/5 & L-5/S-1 into my hips. It is relentless and is only stopped by lying down. Good Luck and let us know what the doctor has to say.


Thanks.

The pain you described is exactly how mine is too. It only really helps to recline.


And, I guess I'm unable to update with anything because...ugh. I had to have someone drive me an hour and a half to this doctor. When I got there, the receptionist asked who my appointment was with. I told her and she was just like 'he's not here today.' My stomach sank when she said that. She said my appointment was made for the other office that he sees patients at, which happens to be like 2 1/2 hours away. The neurologist office that made my appointment is literally across the street from the office that i assumed I was supposed to go to. When I wrote down the directions from the neurologist, they specifically gave me ones for the office I went to. So I think it was the Ortho's place that messed it up.

Either way, I'm very disgusted today. Made someone drive me somewhere for nothing. Not to mention I forgot my medicine and felt awful on the way back. So now my appointment is for next Friday, the 25th. The receptionist apologized, but it's having to make a trip like this is a big deal for me. I was nice to her of course, it isn't like it's her fault. And if it was, accidents happen...It's just like why do they always happen to me? lol

So another week. Ugh.
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