Hi I am new to the forum although I have been doing alot of reading. I started having back problems in Dec 07 when I hurt my back at work tranferring a client. I have since been doing physio and trying different meds to cope with the pain. I will post more in the forum. Glad to have found this site. I have seen a neurosurgeon twice..once for the original injury and then was called back in regarding my second MRI which showed more detail about some cysts I have. Here is some info from my MRI's
Results of first MRI
- Facet joint osteoarthritis from L3-L4 to L5-S1 bilaterally
- At L5-S1 there is loss of intervertebral disc height and desiccation of the disc. There is a disc extrusion into the right neural foramen and this is in direct contact with the exiting nerve root. There is generalized bulging of the L5-S1 disc as well.
- There is a cystic lesion seen in association with the right S1 nerve root in keeping with a perineural cyst. It measures 1.1 X 1.6 cm. There is another lesion which measures 1 X 1.8 cm within the left neural foramen at L1-L2. It extends posterior to the conus. There is discontinuity of the ligamentum flavum at this level. Lsion demonstrates low signal intensity on T1 and high signal intensity on T2
- Impression: L5-S1 DDD with a foraminal disc extrusion which is in direct contact with the exiting right L5 nerve root
- Cystic lesion in the left neural foramen extending into the spinal canal at L1-L2 query perineural cyst…….
Was called back in for MRI with contrast because of cysts and these were the results
There is a dumbbell shaped lesion of fluid signal intensity in the extradural space at L1-L2. It is located along the left lateral and posterior aspect of the spinal canal and conforms to the shape of the canal measuring 2.3 cm tranverse X 2.3 cm craniocaudal X 1.0 cm anteroposterior. It extends towards the proximal aspect of the left neural foramen but not into the neural foramen. It is not clearly associated with the nerve root. There is no enhancement following the administration of IV gadolinium.
This lesion does cause some mild mass effect on the conus medullaris and nerve roots forming the cauda equine, although overall there is no significant central stenosis. There is potential for some encroachment of the left L1 nerve root in the proximal foramen.
At T9-T10 there is a right paracentral disc protrusion mildly deforming the right anterior thecal sac and right anterior cord, but without causing central stenosis.
The remainder of the exam was unchanged from the previos.
Opinion – Extradural simple cystic lesion in the left posterior canal L1-L2. This is most likely an arachnoid cyst. An epidermoid cyst could also be considered in the differential but would be rare.
When I first had my injury the pain was excrutiating. Didn't matter what I did..If i moved or tried rolling over in bed or anything it was feel like someone was stabbing me. Now the pain is different and I am wondering why the change. I seem to have constant "nagging". My right side seems to be worse but some days both are equally painful. It is hard to explain the pain really. It is weakness, burning, almost feels sometimes like my leg is heavy, not there, "thick". Like I said it is hard to describe. I have tried many different meds...naproxen, celebrex, tramadol, lyrica, hydromorph contin, with no results. I am now trying amitriptyline and it does not seem to be working either. I take endoct as needed but it does not take the pain away it really only makes me "stoned" and then I really don't care about the pain. I try and take it only at night because I have a four year old. I have been doing physio 3xweek since January and we are still only doing muscle stim with heat and the ultrasound. Therapist is concerned because we have tried starting a routine of exercises but the pain gets so bad that I can't do it. I know this is a long post and I apologize...but my husband is very unsupportive and is only concerned about when I can go back to work...He just doesn't seem to get that the pain doesn't go away...I do have good days but they are few and far between. I have an appointment scheduled with a physiatrist at the end of sept but I am concerned that with the pain being so constant that something has changed. I would appreciate any suggestions from anyone out there who can make any sense out of my MRI's. The NS that I saw had a terrible bedside manner...Didn't explain anything and said he would not operate. Told me to continue doing what I was doing. Family doc and physio were very surprised that he wasn't going to operatesince my recovery time would be minimal comapred to the length of time to heal naturally. I am at my wits end. Work is hasseling me to come back and doc refuses to let me. I am going stir crazy from being isolated with my four year old. I love him to death but it is hard when mommy cant play all the time...Help! :''(