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I am scheduled for Radiofrequency Ablation on the 22nd for my lumbar area and my SI joints. However, in the meantime my PCP sent me for an MRI because of hip pain I have been having for the last year or so. I am not asking anyone here to explain to me what this MRI means, but I do have questions about the benefit of the RFA based on my new MRI results.

L1-L2: Osteophytic spurring which causes mild to moderate central canal stenosis, w/o significant neural foraminal narrowing.

Old L2 compression fracture with approx. 30% loss of vertebral body height.

Large Schmorl's node within the superior endplate of the L2 vertebral body.

L5-S1: Central disc protrusion which causes mild to moderate central canal stenosis w/deformity of the anterior aspect of the thecal sac. No significant associated neural foraminal narrowing.

1st question: Based on your knowledge or your experience, should I expect to get relief from the RFA based on my new MRI findings? Or are these not the kinds of things they even do the RFA for?

2nd question: What exactly is a Schmorl's node? Do you have them and how do they affect your pain level if any?



  • Definition of Schmorl's
    Definition of Schmorl's node

    Schmorl's node: An upward and downward protrusion (pushing into) of a spinal disk's soft tissue into the bony tissue of the adjacent vertebrae (the bony building blocks of the spine). Schmorl's nodes are detectable with an x-ray test as a spine abnormality .

    Schmorl's nodes are most common in the middle and lower spine.

    Schmorl's nodes are common, especially with minor degeneration of the aging spine. Schmorl's nodes usually cause no symptoms, but reflect that "wear and tear" of the spine has occurred over time. Schmorl's nodes are a helpful x-ray finding as an indicator of degenerative process that may be affecting a patient's spine.

    If I were you, I would ask the pm doctor about going through with the rfa at this point, and possibly consult with a surgeon about the canal stenosis. RFA is usually done to burn the nerve fibers in the facet joints when they are suspected of being the cause of ongoing pain. Central canal stenosis is not going to be relieved by the rfa ......the only way to relieve that would be surgery to remove the compression of the canal if it is serious enough that it requires it. Other treatment options include injections to try to soothe the area....
  • Thank you for taking the time to give me such a detailed response, I do appreciate it. I see my PM dr. on the 14th, a week before the RFA is scheduled. I will be taking the new MRI report and disc with me and discuss with him what we will need to do give the new information we have. I'm sure that they will recommend physical therapy, since my PCP said that a surgeon won't even talk to you until you have tried PT first. Do conservative measures ever help with central canal stenosis?

    I was sure that RFA wouldn't be of any help to me at this point but just wanted to ask people who have been where I am now just to be sure.

    For quiet some time now I have found being able to walk for any distance or amount of time to be near impossible. Sitting or laying down does help relieve the pain, but there's just not a lot I can find to do with myself being in those 2 positions all the time. Anything that involves me being on my feet has become excruciating. Within 10 minutes of grocery shopping I find myself needing to lean over the shopping cart handle for relief & can't wait to get back home. There is no doubt this has affected my quality of life and has for quit awhile. Whatever it takes to feel normal again I'm willing to do.
  • sandisandi Posts: 6,343
    edited 04/06/2014 - 4:57 AM
    What you are describing with the sitting to relieve the pain or leaning over the grocery cart is so typically central canal stenosis.....to a "t". As far as conservative measures go at relieving the pain of stenosis in the canal, it really depends on the severity of it....if it is mild stenosis, then sometimes strengthening excercises can help to ease some of the symptoms and using some tricks of posture and knowing how to bend or lean can relieve the symptoms, as well as learning how far you can push yourself/pace yourself but in cases where moderate or severe stenosis are present, surgery is usually the only option to permanently relieve the compression.
    I know that it is not what you or anyone wants to hear, but the laminectomy /decompression surgery if stenosis is the only problem usually is not as difficult a recovery as some of the other surgeries out there, although it is still a spine surgery, and you need to be careful following surgery until you are healed, it is one of those surgeries that usually relieves the symptoms right away.

  • Ty, sandi, for the links I have already read several of them. There is definitely a lot of information to take in but it is very important for me to understand all this and what it means for me. When I have to go through something medical I like to be as informed as I possibly can be. It helps me to know what questions to ask and to know what to expect before during and after any kind of procedure. I feel one must be their own advocate in order to get the best possible care and outcome.

    Today, was the first time in a long time that I opted out of grocery shopping because something so simple, as getting groceries for the week, gives me great pain. Sometimes, with all of this happening I just feel absolutely useless. I hate having to relinquish parts of my life to others to see to--but I do know my limits and for now I know there's not anything I can do about all of this. It's going to take medical intervention, of some kind or the other, to make this better or at least tolerable.

    As far as being a good patient I can do this, I have had to before. I will say though at times it's not easy, especially when you like doing things for yourself. But, I know that after a dr/therapist or surgeon does their part then it's up to me to do my part and I know my part will have a lot of restrictions, which I will do. I'm a planner so anytime anything has to be done to me, I plan everything out that has to be done before hand and make sure it's done so that recovery will go smoothly. So whatever has to be done to fix my lumbar problem you can bet that I will be doing my part 110%.

    Ty again for taking the time to give me the links, I will finish the last couple up in the morning.
  • I have Schmorl's Nodes "scattered through thoracolumbar junction" and I have a lot of pain there, at times I'd say it is severe. Like bulging discs and other degenerative changes, they can be asymptomatic so are not always a huge cause for concern when they show up on an MRI. It is probably hard for you to know if yours is painful, because you have other problems at that same level as the node.
  • TarenTTaren Posts: 525
    edited 04/07/2014 - 12:58 PM
    " It is probably hard for you to know if yours is painful, because you have other problems at that same level as the node"

    mcjimjam, My dr called this morning & said pretty much exactly what you had told me about schmorl's nodes. I see my PM next week about all this to see if he suggest trying PT or just go ahead and consult with a surgeon. I'm sure the RFA will be out now.
  • My dr has decided to go ahead and try the RFA any way for the facet and SI joint arthritis I have. It's is still scheduled for next Tuesday, the 22nd. He says it won't help the stenosis I have but will, hopefully, help with the arthritis. I'm hoping it helps too. I guess my question is, even if it helps the arthritis I have, wont I still be having pain from the stenoisis? Is he just hoping to kill out half the pain I'm having?
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