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kyadog115kkyadog115 Posts: 266
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
I just returned from the neuro. I brought him the MRI disc and the report. He came in the room and I said to him "How bad is it doc" He said, " There is nothing wrong and the MRI looks fine" end quote............I dont get it ! Then I had to show him what portion of my foot was numb, he went back and viewed the disc again, returned and said there MAY be a "slight" herniation. He said sometimes people w/large herniations have no pain and small herniations do have pain. To make a long story short, we agreed to an oral steroid for 6 days,if no relief , then injections in the O.R under mild sedation (cuz I get nervous&scared)....then if no relief perhaps a second Micro'd.........however, he said doing 1 the second time is more difficult than the first time...he didnt elaborate, Can someone please comment on this insanity?My back is killing me, I know there;s soomething wrong w/it. Should I get another opinion? Tomorrow, I have full intentions of calling the hospitals radiology dept to see what they say, Please respond with your opinions, cuz I'm dumbfounded !


  • Well, I guess that's good and bad.
    Good news is you didn't re-herniate (or it doesn't appear based on what you wrote). The good news is you have a plan. Sometimes, scar tissue builds up or the area (slight herniation) does cause enough inflammation to create pain.

    I hope the oral Steroid works. Based on duration, it sounds like he's going to try a Medrol step pack. Hopefully that will provide relief. If it does, it's an indication that there was swelling/inflammation.

    I was on a double Medrol pack (6-day) and got no relief.
    After my surgery about 6-weeks in, I was on Prednisone for 9-days and got maybe partial day when I hit the peak dosage. Medrol isn't that bad...you may get a little jittery (like caffeine but not as strong as prednisone at least in my opinion).

    It never hurts to get a 2nd opinion but I would go ahead and start the oral steroid for 6 days as directed b/c if it provides relief at least you have a good indication that inflammation is what's causing the pain.

    I would call to try talking to the radiologist to say "can you explain in layman's terms what the MRI report means?"

    Also - I think others will comment so sit tight and see what advice others have on how to progress.


    2nd MicroD is not as simple as the 1st but is still lower risk. Of course, if he's planning to do that, you'd want some sense of why he thinks that will help. If he sees a small piece, he would go in and clean up scar tissue along with whatever small fragment he can see. It's more difficult b/c your risk of infection goes up and they have to cut through scar tissue which could actually irritate the nerve a little more than the first time. There's a few other things too but he's saying that probably to let you know "it's not a decision to jump into without trying some alternatives".
  • Howdy Paul,

    Sorry to hear that they really haven't "seen" anything that is matching your symptoms - many of us have "been there, done that and sadly, worn the shirt." Is it possible to get a Stand Up MRI? It puts your spine under load, and too in the position that hurts - such that the doctor might see what is "hurting" you.

    I have a lot of issues with my lower back, and though the area shows "problems" - to me they don't look like something that matches my symptoms (could be wrong, waiting for an appt.). I may ask to re-do my MRI via what I wanted in the first place but wasn't done - a stand up MRI. Please keep us posted!! *HUG*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi Paul! I am sorry you are in so much pain and I understand how upsetting it is.

    It is true what your neuro said re MRI'S don't always tell the complete story. Pain is so individualized and somtimes someone can have a large herniation and not feel pain and other times it can be quite small and cause that person alot of issues. Often doctors won't even look at the MRI until after they have thoughly examined you.

    I think you should get a 2 and maybe 3 opinion and since you have been seen by a neuro, I would make an appointment with an orthopedic surgeon who specializes in the spine.

    I do agree with his plan to treat you conservatively as you really don't want to rush into spinal surgery if you can avoid it.

    Personally I have had many, many injections and they really aren't that bad. They will sedate you, you don't remember it. If it works, it is such a wonderful relief!

    I hope this has been helpful! Do you know what your MRI report said? What level was your previous micro?

    Take care and keep us posted Shari
  • Thanks for the replies. I do agree that a conservative approach may be best initially however, I do not understand why the MRI report, from a Medical Doctor who specializes in this area indicates a ("fissure) with mass effect on S-1 Nerve root and then the neuro tells methe MRI looks fine. Certainly, u all can c that this is contradictory.
    I'm certainly no Dr. But i can read the report....it says HERNIATION.........so, is there one, or isnt there?
    To Jayhawk...the level is @ the L-5. This is the same disc that I had a micro'd on in April 09. I firmly believe the fall/trauma to my back caused this re-herniation. The Neuro did say that if my symptoms arose right after the fall than most likely it could be attributed to this fall.Nonetheless...in my estimation, the point here is............is there a herniation of the disc and is it impinginging the S-1 Nerve root as is stated on the MRI report?...it doesnt appear to me that it's subjective. Either it is or it isnt't.,,,,,,,,agreed?
  • Did the Doctor do a physical exam? Normally they will test your reflexes and maybe walk on your toes and heels. The doctor will then combine all of the information including the results from the MRI to determine the best course of action.

    It sounds like this fall you had has set you back a little. The good news is it appears that you did not re-herniate the disc. I'm sure that must be a load off your mind. In addition to taking the oral steroids you need to work on stretching your hamstrings so you can free up the nerves in your back. Probably do some ankle pumps with your legs slightly elevated. The steroid alone will do nothing for you long term, it needs to be combined with some PT.

  • To answer your question, reading an MRI can be subjective if the problem doesn't jump out at you. There have been people in this forum who have written out there entire MRI report with it saying they had a herniation at a level that was previously removed and fused. The reports can be rather boiler plate at times.

  • Dave.."boiler plates?".....i guess so... The report ays herniation @ l-5,,,,,,,,,,all he did was fel my foot,it's totally numb at the exterior portion, left foot............my left calf muscle is throbbing. Cleraly, somrthing is not right...............I'd appreciate any other answers& opinions..............at this juncture, enough is enough.......I was fine until the fall........i get a report from an MRI saying herniation/fissure............i'm in a lotta papin,i got a dr, thats says he doesnt c anythingthing and the recants,,,,,,,,,c'mon,,,,,,,,,,?
  • Like Someone else said, try a orthopedic surgeon that specializes in the spine. I would try every non surgical thing I could do. I was in the same position with my MRIs after my laminectomy, they couldn't see anything but I was hurting. My neuro said we could do a fusion, but I can't tell from the MRI if its that bad and I can't operate unless i'm pretty sure. I waited 2 years thru the pain, did every non surgical thing in the book. Went to a Ortho and this time, my disk changed on the MRI to black as all be, my disc was shot. So they did the fusion. I was in pain the whole time, but it didn't show at all on the MRI for 2 years. But if I could have avoided this fusion I would have. Good Luck. ;)
  • It's well known that you can take the same MRI to 10 different docs and get 10 different diagnoses. So, that being said, I'd really find a fellowship-trained spine surgeon, ortho or neuro, but one that only works on spines.

    I also wouldn't bother calling the radiologist for his opinion because he's not a doctor, just a radiologist. They're very important in what they do, but reading MRI results and determining what it means isn't one of them.

    There have been some members who've needed to get a few opinions or more, not to find someone who says what they want to hear, but to find a surgeon that they have confidence in and feel they can trust. You obviously don't trust this doc's opinions, so find one that you can trust. Sometimes that's half the battle.

  • Cath..
    I think your are mistaken,at least according to whatI'm told Radiologists ARE MD's.........They are in fact Medical doctors and i'm told to believe more what they say than the neuro because this is their ("forte') So to speak.
    I'm going to seek a 2nd opinion iin this matter. Thats my decision at this juncture.
    Thanks for your input

  • It's good you're getting a 2nd opinion. I'm glad you pointed out to the Dr. there's a herniation there although unfortunate it herniated again. I had the same herniation and small but bad enough to put me out of work for 2 years. The small ones are big when they're impinging the nerve and releasing all those pain chemicals on the nerve. Best wishes on your next Dr. appointment. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Charry,,
    Thanks for that. It's good to have someone understand me. I dont know if this is a "small" herniation or what..i couldn't really get a straight answer outta the doc but all i know is it's killing me.
    There might be litigation in this matter too and i'm told that could be part of the reason for the hesitation w/the Neuro....they dont wanna get involved...
    Take care

  • Paul

    I actually had a ortho surgeon look at my MRi and report that said herniation and tell me he didn't see anything. But he said at least I had something good to use in a lawsuit!!

    The neurologist didn't get the report but looked at films and said nothing there.

    The neurosurgeon took 10 minutes to find the herniation. Then he admited that if he didn't know where to look from the report he would never have found it.

    End of story there was a herniation and it was causing my pain. But it took four doctors, 5 MRIs now and 9 months to get the final answer.

    So don't give up and get more opinions. I know it doesn't seem right but that is modern medicine.
  • Kris..
    Thanks for that. I'm sorry for you but glad I'm not alone. Thats all crazyness. I just dont understand it........I'm far from a doctor but If the Radiologist reads the MRI and states"Herniation""Fissure" "impinging S-1 Nerve root" what more is to be said? Thats how i see it anyway.

    Good luck to you..
  • I was very insulted when that surgeon implied that the radiologist was making something up for a lawsuit. However I have to say that in the last year my eyes have been opened to all the shady lawyers and medical professionals.

    The day after my accident I called my orthos office but he was on vacation for a week. So I called a good friend who had recently had a car accident and needed surgery. She told me to call the lawyer first because she lost alot of money in her settlement because she made some mistakes with doctors and treatments. So I did. I told him my doc was away but I wanted to get checked out because I was afraid there was damage. He set me up with a doctor that afternoon. Well I was stunned when I walked into this office. It was a PT mill. The doctor was a chiropractor who took down a statement of the accident and took an xray with old equipment and told me to come back in two days. As we left he office I saw people walking in, signing a book and walking out. Guess they were establishing a treatment record. I was shocked!

    Then I went to his ortho who worked out of a PT gym. The exam room was like the changing room at Macys. He wanted me to start PT before he even sent me for an xray(no equipment in this "office")

    There are alot of scam artists out there. Unfortunately alot of good doctors have encountered this as well. In my case I think that first surgeon was only interested in "big" cases. Remember this was the same time they announced that herniated disks heal just as well on their own as with surgery. Doctors have to defend themselves to the medical boards and the insurance companies and the hospitals. A good doctor will try everything before doing surgery.

    Now that doesnt mean that they don't make mistakes. Also it's a judgement issue. Every time they touch the spine there is a risk of causing future damage. Sometimes they wait so you will have more time down the road. Don't stop asking questions. Knowledge is power.
  • Kris,
    Thats quite an interesting story. Are you in NYC? I wouldn't be surprised if you are.....thats not to knock NYC, but I;m sure in big cities like that there are scam artists and crooks alike.I was not aware of any such announcement re: discs healing on their own as opposed to surgery. I'm new to this part of it and have never sued anyone in my life. I'm a renter, slipped on icy steps here, the landlord lives in Florida and has been negligent in maintaining this property. I'm in upstate NY (Albany)...Once i fell i did contavt an attorney but he advised me we needed to wait till all medical tests were complete. I did that and once the report indicated disc herniation, they took the case. TRuth be told, I'm not trying to scam or hurt anyone but on the other hand, I cannot absorb all these medical bills either. More importantly, is my back. It's is killing me and after I had the first micro'd 4-09..i was fine. Now, I'm back to square one.
    I appreciate your comments&input..
  • Hi Paul:

    It sounds like you're making all the right moves. The only thing I haven't seen is any thing about a Cat-Scan. Sometimes they can be more definitive in conjunction with the MRI. Some of my problems were seen on the MRI but my Ortho insisted that I also have the Cat-Scan as well to make very sure of what was going on in my back. Turned out that the Cat showed even more damage to L2-L3 as well as L4-L5. I also sent all my info to several spine docs to get their opinions as to what I had to do. I live in an area where there are not many good spine docs so I looked all over the country to get opinions. I picked the one with the most experience working with what I have going on and he will do the surgery with the least invasive procedure and NO rods and/or screws. I have about 3 weeks to go till surgery and I'm still looking for as much info as I can find about ourcomes for this type of surgery.

    Hope all goes well for you. Marsha
  • Hi Tahogranny.....
    Thanks a lot for that because I never thought of it....but then again, why should I have too? I would think these Doctors would recommend these types of tests to me.
    Nonetheless, I'll inquire about that one at my second opinion meeting.You dont specify what it is you are having done. I wish you the best anyway...


  • Yes, you are correct, Paul. The radiologist is a medical doctor with a residency training in radiology. They do more than read imaging tests. They are also very much involved in the relatively new field of nuclear medicine. This is a field that requires careful training as they are working with radioactive materials, in some cases.

    I think Cath was thinking of the radiologist-technician who performs the tests.

    You can make an appointment for a consultation with the radiologist who read your films, or you can take the films to a new radiologist if you want another opinion.
  • Gwennie..Yes I agree, that is probably what the other poster was thinking of. I did not realize that I could actually consult this radiologist, thats news to me...thaks for informing me, I might just do that..

  • Welcome to modern medicine. You are your best advocate. As such it is up to you to learn everything you can about your problem and possible treatments. This forum is a great start. The internet is a wonderland of info. Just remember that not everything you read is the truth.

    When you go to the doctor you should have a written list of questions and room to write answers. Also it is good to have someone with you. Two views are better than one. Often we tend to hear what we want and not the whole story.

    Second and third opinions are essential. Every doc has a different idea. Don't be surprised that one will say do nothing, one will say emergency surgery and one will book you for a month from now when they need to fill. And there can be good reasons for each answer.

    Seeking medical care is not easy and can be very frustrating. The problems we have can't be fixed with two aspirin or a bandaid. But don't give up. There is an answer and help to feel better.
  • HI Kris..
    Agreed& thanks

  • On April 7th I'm having PLIF to fuse L2 to L5 due to severe DDD and Scoliosis. I'm also not too happy about what has to be done, but as I've said before on other posts, I've run out of options. I'm nervous about the whole process but I've gotten lots of encouragement from this site (it helps). My next problem is: how much will this procedure limit what I'll be able to do mostly mobility. Will I be able to bend over at all, tie shoelaces, blow dry my hair, pull a polo over my head, etc., simple things?

    Glad I mentioned the Cat-Scan to you. Hope you get good info on what to do!!! Marsha
  • HI
    I see. I agree too, i'd wonder the same things. have you asked your doctor about limited mobility? I'm afraid thats what eventally i'll need too (fusion)...
    All the best of luck


    And, thx for the cat-scan advise, I'm going to ask about it
  • Oh, I know all about horror stories in diagnosis and treatment. I am SO sorry to hear you're dealing with it.

    Allow me to commiserate:

    It took me an agonizing five YEARS to get my problem diagnosed. Had surgery. Didn't work. Took me another FOUR years to get a competent doctor and health coverage to take care of me.

    My problem was spondylolisthesis at L5/S1 which got progressively worse after the initial physical trauma that started it suddenly at 17 years old.

    I saw a multitude of specialists nation-wide, had xrays, MRIs, the works. Nobody had an answer. I had given up, and then after a year one unlikely doctor decided to take xrays with me bending forward and backward, instead of standing/laying straight. Lo and behold, my injury was obvious. After all that time, all it took was me bending a different direction.

    After my first fusion which ultimately failed, I moved to Oregon from Maryland. I got some free xrays done at a local hospital and sent them to my old surgeon to get looked at. He was amazing enough to keep tabs on me after I moved since I didn't have health insurance anymore. He said there was evidence of pseudarthrosis and loosening of my hardware and told me to go see a local doctor asap.

    The first neurosurgeon I saw left me in tears. He took one look at my recent xrays, said they looked "fine" and dismissed me. His receptionist even had the moxie to tell me I was just DRUG SEEKING (probably because I'm young, tattooed/pierced, etc). I couldn't believe it. There I was, now 24 years old with a failing spinal fusion, in chronic pain and not being taken seriously for even 10 minutes.

    I called my old surgeon in Washington DC, in tears. He told me to go see a doctor at a TEACHING HOSPITAL. Best advice I've yet to receive.

    So I took my xrays to a doctor at OHSU, who had the sense to do a CT (whoa, no way!) and it was then glaringly obvious that I had a screw coming lose from my spine.

    This was followed by a series of fiascoes and disappointments regarding health coverage to get the surgery I needed to fix the problem. It was medically coded as "clinically insignificant spondylolisthesis" which was considered an ELECTIVE procedure. None of the low-income/free healthcare options I had would even consider covering it.
    24 years old, screw twisting out of my spine... elective surgery, yeah right.

    I got married last year to a friend so I would have amazing health insurance. That's the point of desperation I reached. And now I've got a great doctor, and I'm having my second fusion in 8 days.

    It's been 10 years of hell, but I think it's going to work out this time.

    So don't give up. If you don't like the treatment you're getting from one doctor, go see another. You know your body, you know your pain, you know the severity of your injury (whatever it may be), so don't let anybody write you off.

    If I'd have been taken seriously from the get-go there's no way I'd have just spent more than a third of my young life in chronic pain. But that's modern health care for you.

    Stick with it! Do NOT give up!
  • Hi,
    Thanks a lot for taking all the time to write that. Thats a hell of a story for sure. "Drug Seeking?".....I know about that nonsense too..In fact thats what the neuro said to me just recently.."I'm not perscribing you narcotics". I told him I have them from My PCP and wasnt asking for them.He is an arrogant F**k in my opinion but right now I need him. But ur right, I'm trying to get a referral to another Dr for 2nd opinion, I wont give up, I fell and have a herniation that I shouldn't have. Now I might require surgery again.....someone's gunna b held accountable for this injury as it was a case of property neglect that caused my fall.This surgeon i just saw gave me a script for the medrol steroid pack, didnt help at all,so he said if it didnt't we'd do ESI in the Op.rm..I know thats game too cuz I had them in my cervical spine....temp relief, if at all !

    I wish you all the best of luck w/surgery.. I hope for you it's your last one and permanently corrects the problem.It's no fun at all, I know.

    Good luck

  • Def get a second opinion, but with my experience, I have been 18 yrs in pain and the last 10 years being the worst, but my MRI's didnt really show anything significant enough to operate until just recently, also my age stopped my PCP from referring me to a Neuro for surgery...Might take some time for it to show a more progressive stage...I know what you are going thru!

    Wish you luck!
  • These doctors and office staff throw around the term "Drug seeking" behavior too loosely in my opinion ESP with ppl like us who are in much need of some sort of relief from our pain! I go thru doctors EVERY 2 years cuz they are afraid of the DEA I guess! But they cant deny me pain meds because of what my MRI's show...I hope to hell they dont have to experience what I have had to!

    I had a Neuro wayy back when I broke my back and they use to make me stand, and lay down for my monthly MRI's...
  • Hi
    Thanks for the comments. I agree that they use that term too loosely.It's ridiculous to put it mildly. I've been on Narcotic pain meds for nearly 2 years and i still have apprehension each month when i see the Dr, that he's gunna "cut me off". I realize they dont want u on these drugs and they can b abused however, when legitamately needed, there should be no issue. I get long acting meds, and the short acting for B/T pain...NOw, they r beginning to wein me off the B/T...each month they are reducing the count...it was 90..then 75,then 60, now 45...
    Guess I;ll need to go black mkt....if i have to.
    I assume u r fairly young as u mention they didnt wanna send u to Neuro cuz of ur age. I am gunna get that 2nd opinion...I wish you all the best and again, thanks for replying.

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