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L4 spinal canal stenosis

LawlessLLawless Posts: 2
edited 06/11/2012 - 8:54 AM in Spinal Stenosis
Hey everyone,

I've been searching the internet the last few months for information about my back problems, and haven't seen many cases similar to mine. Long story short:

First, me- 38 year old male, full time firefigher/emt, and I used to be very active (running, swimming, weight lifting, cycling, etc) I have large frame (6'3" 225lbs) with minimal body fat. I had back spasms when I was younger, but strength training corrected those with no problems in over 2 decades.

Last couple months of 2010-back pain that began as mild and continued to get worse, went to doc and was told it was probably back spasms.

Early 2011 Pain continues to increase, as well as numbness and loss of motion of toes on right foot -Xray showed advanced DDD at L5-S1, doc scheduled MRI but figured the disc was herniated, started physical therapy and hydrocodone for pain

Therapy helped with numbness and loss of movement, helped slightly with pain. My activity level (since late 2010) has continued to diminish due to severe pain. Hydrocodone helped with pain, but was only a temporary solution to problem

MRI is completed. Neurologist informs me that yes, my disc between L5-S1 is in bad shape, but that it is not causing my problems, he shows me the MRI, and how my spinal canal is wide open everywhere EXCEPT my L4 vertebrae, which is narrowed considerably (about 1/4th the size of the others).

This was about 8 weeks ago, and the doc told me to do as much strengthening and exercising as pain would allow, which I've done. Sadly, I am not able to do nearly as much as I used to, and my follow up is in a couple days, upon which time I'm going to inquire about surgery options.

I'm not ready to give up my active lifestyle, or my career, at this point. I want this fixed and I want to be able to exercise like I used to. What kind of surgeries should I be looking for? I see websites promising minimally invasive surgeries, but is that an option for canal stenosis? I'm not sure if anyone here knows the answer, or of the options I'll be presented with, but any answers I can get before I talk to my neurologist would be appreciated.

Thanks for reading this novel :P



  • Big welcome here to Spine Health. Sorry that you need to be here.

    I too have issues with my lower lumbar, am close to you in age, and am also in the healthcare field (nursing)

    It is great that you are going to see a neurologist, but have you been to see a neurosurgeon or spine fellowship trained orthopedic surgeon? Have you tried any other conservative treatments, such as ESI's, tens, heat/cold? If surgery is recomended, please go and get a second, third... opinion.
    I can't recomend a certain surgery for you, only your doctor can do that.

    Wishing you all the best, please keep us updated on how you are doing and how your appointment with your neurologist goes.

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • Hi Karen,

    Thanks for the quick reply. I have tried heat/cold, as well as stretching, and other physical therapy, with limited (early on in treatment) to currently no relief. Have not tried ESI's or TENs, though from everything I've read, they offer short term and questionable results. Have you used either? Were they effective?

    My main issue is that I'm just tired of not being able to run/swim/cycle or do anything else that requires any quick movements. I basically can walk or limp (depending upon the pain at the time) around, and that is about it. Missing work is also becoming an issue, though there are days when I fake it enough to go, it's only a matter of time before something happens at work and I am unable to do my job. That puts the public and my co-workers at risk, which is unacceptable to me.

    The reason I'm considering surgery now is because the narrowing is only going to continue to get worse. My wife is tired of me being constantly grumpy because of the unending pain. I'm still relatively young and reasonably fit.

    As you said, going over things with my doctor(s) will hopefully clear up some of my concerns. But I'm not accepting anything short of complete relief of pain and an ability to resume a very active lifestyle.

    Thanks for reading,

  • Lawless,

    Welcome to Spine Health!! Sorry to hear you have stenosis, and conservative methods aren't working. Did your doctor say what is causing the stenosis? That can make all the difference in what kind of surgery (if warranted) they would suggest or offer.

    One of the BIG things you need to realize is spine surgery is nothing like 95% of other surgeries. My appendix goes bad, they take it out, I heal from the incisions and life goes on. Conversely, spine surgery is so complex in bone, disc, muscle and the biggie, nerve involvement. Recovery can take months to years! The other biggie, spine surgery most times won't "fix" you.

    The goals for spine surgery varies from preventing paralysis, restoring function, preventing further damage, freeing up nerves etc.... An honest surgeon will tell you surgery won't necessarily 'fix' you. Fix is a scary term when it comes to spine surgery. We all hope it will. My first fusion (to me) was a 100% successful (fix) surgery. I was able to return to full duty within 4 months (pilot and law enforcement). My next fusion, not so lucky - nerve damage.

    Hopefully your surgeon and you will talk soon so you will know what options are there for you. Please let us know how it goes. Again, Welcome aboard!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi I feel you the pain is so unbearable at time for me. i am a school bus driver and there are days I couldn't work and then there were days I work when I should not have. Have you found any relief yet. I am looking for some suggestion also. ok this is gonna sound weird but i got relief for 2 days it was amazing those 2 days . Orange peels massage on your back it sound weird but it did work . it might have only been two day but it was the best I felt in months. I am doing it again this weekend. good luck
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