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Spinal Stenosis with Severe Neural Foraminal Narrowing. Need advise and support

nursekmnnursekm Posts: 10
edited 02/24/2015 - 8:25 PM in Spinal Stenosis
Hello All
I would like to start by saying hello to everyone out there, I will try to be as descriptive as possible but I cannot stay in this position for too long so I will apologize if I have left out any important details. I have had back pain since the age of 20, and I am 35 now. It began as mild pain in the neck and upper back. My early xrays back then showed Loss of cervical lordosis and DDD. I began taking Methadone at the age of 26, for an addiction which i suffered from. I stayed on methadone for 9 years. and when I decided to take the steps to come off of it about a year ago I realized I was in trouble because that is when I started to have severe pain which I am assuming was being masked by the methadone. When I was 30 I started to have more and more pain, I had xrays of my neck and thoracic region which didnt show a whole lot. I asked for a CT about 2 yrs ago, and that showed moderate spinal stenosis and severe foraminal narrowing at mutli levels. The worst area was the c6 area. I also had impingement on the left side. I then had an MRI just a week ago. I will will post the results. I have seen the following drs: 2 Neurologists, orthopedic surgeon, Pain specialists. Chiro, massage, currently seeing a neurosurgeon. I have only had lidocaine shot ltwice ;ocally from my dr in his office, with only mininal benefit, and needing another one within days.
I have tried many drugs here are some that I can rememeber: Cymbalta, lyrica, amitriptyline, flexeril, Tramadol, Topomax, Cesemet. I have been on antidepressents many different ones. They made me gain weight and they didnt work because I am not depressed, they did nothing for pain.
When I was off methadone from oct 2014 -Jan of this year, they were the most painful months of my life. I recently had to restart it and am currently taking 50mg is 3 divided doses daily. I am still having severe debilatating pain the methadone takes the edge off of course.
I want to have another child, and in order to do that I need to get off methadone. My pain and my activities of daily living have gotten very bad. I am not working, I am having a hard time doing the simplist things such as driving, laundry, I cant lift anything really, i cant stand for long, depending on the type of floor 1-2 hrs. Cement floor 30mins tops Walking longer than 15 mins irratates my back and causes a flare up. My pain is mainly in my neck but also along my spine, on both sides. I have some tingling down my left arm into my middle and baby finger. I have pain that seems to be in the siatica area and into my hips and down the back of my leg but not into my foot. The pain will usually be one side of my body, so I could go to sleep with the left side being the problem and wake up and its the right side. Sometimes it becomes sharp, stingy like feeling in my low thoracic region or sometimes itchy. I have muscle spasms alot throughout my back. I am also having pain in the thoracic region too. Pls look over my results fr my CT in may 2014 and my MRI from Feb 2015. I am looking for advise from anyone maybe someone who has a similiar problem and has had surgery. I am considering surgery but I am not even sure what they would do and where they woud do it.
CT-May 2014-cervical spine only
Routine nonenhanced cervical spine with axial images from the top of the c3 to the bottom of T1
Findings: Cervical spondylosis is present. The DDD is mild to modereate at c3-4 and c4-5, Moderated to severe at c5-6, and mild at c6-c7. No significant facet osterorthritis identified.
C3-4 mild right neural foramina narrowing and minimal right central canal stenosis
C4-5 mild bilateral nerual foramina narrowing and mild central canal stenosis.
C5-6 Severe, left greater than right, neural foraminal narrowing and moderate central canal stenosis greater on the left side. Likely there is at least impingement on the exiting left C6 nerve root.
C6-7 moderate to severe left and mild right neural foraminal narrowing and mild left sided central canal stenosis

Impression:DDD resulting in multilevel neuroforaminal and central canal stenosis as described above

Feb 18/15MRI-brain and spine(cervical, thoracic, and lumbar) (my brain MRI is normal so not posting the findings)
Non enhanced cervical thoracic and lumbar spine
Within the limits of artifact through the cervical cord, no cervical cord high signal lesions identified. DDD is present which is mild at c3-4 and s5-6 and severe at c5-6 and moderate at c6-7
C3-4 mild right neural foraminal narrowing and minimal central canal stenosis
c4-5 moderate -severe right and mild left neural foraminal narrowing and mild central canal stenosis
c5-6 severe left and moderate-severe right neural foraminal narrowing and mild central canal stenosis with flattening of the cervical cord
c6-7 severe left neural foraminal narrowing and left sided central canal stenosis

High signal lesion is present in the T9 vertebral body consistent with an intraosseous hemangioma. No high signal lesions identified in the thoracic cord or conus. Early DDD is also present in the mid thoracic spine as well a tiny left posterolateral T8-9 disc protrusion. No central canal stenosis, neural formainal narrowing or nerve root impingement

I am not looking for anyone to interpet my results as I know no one can do that. But does anyone know what a High signal lesion means in the vertebral body and if it is serious. My spine feels so instable that bending over, putting dishes away and sweeping all seem like impossible tasks to me now. I am only 35 and I feel like I am 80. I am worried that the surgeons and doctors are not going to help me, and say that I am not a candidate for surgery. But I cannot continue this way I feel each day I become worse. I dont want to be on this pain medication either. My next appt with my neurosurgeon is Mar 12. But they Dr i see is a retired surgeon, if he feels you need surgery then he refers you to his collegue who is an actual surgeon.
Severe cervical DDD with severe neural foraminal narowing at C4,5,6,7 moderate central canal stenosis Spondylosis& impingement on C6 nerve root, moderate DDD thoracic High Signal T9 Lesion in vertebral body, posterolateral T8-9 disk protrution


  • LizLiz Posts: 7,832
    Welcome to Spine-Health

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    If there are any questions, you can always post them here, send Liz or myself a private message or contact Ron rdilauro@veritashealth.com

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • I have a dr's apt tomorrow to discuss my results with my reg GP I would like to have some type of nerve studies done to determine which nerves are being pinched. I can tell i am having nerve pain because it starts in my neck and travels down my arm, hand, hip and leg. Can someone recommend what nerve tests to have done. I have never had any types of nerve tests done before. I am unsure why I would show inpingemnt and spondylosis on my ct in may and then on mri in Feb they never listed it does this mean they didnt show up? I am just in so much pain and i am declined a great deal since May.
    Severe cervical DDD with severe neural foraminal narowing at C4,5,6,7 moderate central canal stenosis Spondylosis& impingement on C6 nerve root, moderate DDD thoracic High Signal T9 Lesion in vertebral body, posterolateral T8-9 disk protrution
  • also with the lesion and the neural foraminal stenosis that i have are this time sensitive issues? Like will i be worse off if I dont have surgery sooner than later?
    Severe cervical DDD with severe neural foraminal narowing at C4,5,6,7 moderate central canal stenosis Spondylosis& impingement on C6 nerve root, moderate DDD thoracic High Signal T9 Lesion in vertebral body, posterolateral T8-9 disk protrution
  • hi there - I just responded to your comment on a different forum and I checked to see how you were progressing... In terms of nerve tests - this is key for understanding whether you have nerve damage or not, and will determine whether you need surgery. if your NS sees nerve damage alongside the pain they will probably suggest surgery as they won't want the nerves to be permanent impeded. You need to see an neurologist - preferably one recommended by your NS. The tests they run are for muscle activity and also nerve conductive tests to see what's going on in terms of sensory and motor function/damage. They aren't much fun but vital in determining where you stand. I'm due to have them in April. Not looking forward to them but keen to get the full picture, as is my NS. I have to wait a long time as the neurologist I want to see is the best one in my area and it's virtually impossible to get an appt with him.
    Good luck and keep us posted!
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