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From walking to wheelchair in one year

Big CarlBBig Carl Posts: 2
edited 11/20/2015 - 9:44 PM in Lower Back Pain
Hi all,

Been reading up but after today's news(2nd doc that doesnt know whats wrong and will not perform surgery) I have decided to make a topic and see if anyone has any answers. I have been looking on this site and others and I am clueless as to what is going on - as are the doctors it seems.

My father(74y.o.) fell in the bathroom last November. It wasnt a bad fall, he says he fell flat on his butt drying himself. He was able to get up and did not have any acute pain. I should also state before this fall he was not in the best of shape, and overweight and had problems walking before and with balance(which is why he fell in the first place!)

Fast forward a few months and he starts noticing this nagging pain that was getting worse and worse. He had to use a cane to go to my mother's 70th birthday party(April 2015). During this time he started to move less and less because of the pain. At this point it started getting bad enough that he couldn't sleep in his bed as he would awaken during the night with pain. He would sleep in the our home office in a the office chair and rest his head in a pillow on the desk. He also started getting vicious muscle spasms in his back constantly. He legs also started getting weaker and not as responsive to what he was telling them to do. We made an appointment with a doctor at this time. The consensus was mild stenosis and a mild fracture in one of his vertebrae.

Back and forth to different doctors and specialists we went. Around July we went to the doctor and a simple cane had to be replaced with a walker. He couldn't make the full walk to the doctors office and had to take a seat to rest a while before he could get to the office. This doctor would not do any back surgery until he lost more weight and he has now(from 320lbs down to 260lbs) but he is on a waiting list until at least February of 2016. We went on to look for a doctor that would do the operation sooner because of his condition.

At this time he contracted cellulitis in his legs and had to go into the hospital for a week. After his discharge he was put into a rehab/nursing facility where he stayed for 3 months. In here he was doing physical therapy. While the spasms went away it seemed the pain from standing has gotten worse. He was doing walking exercises there but it seems like he was at a standstill because of the pain he was experiencing.

He just came back home last week, but any hope of walking now seems dim. I have to help him into bed as he stands from the wheelchair and plops down into the hospital bed we bought. He has a double whammy of back pain and weakness in his legs. He can move them but cant lift them much at all in a seated position. He is on pain meds which help. He has constant pain when sitting but when standing it starts really hurting immediately. Does anyone know what might have happened given this quick synopsis and his symptoms? I looked up a ton of stuff on this site. It seems like spinal stenosis but the MRIs show it is only mild. I have his latest MRI report here(July 28th):

Alignment: There is normal lumbar lordosis. There is no spondyllisthesis.

Vertebrae: There is no loss of height in the vertebral bodies or abnormal bone marrow edema pattern to suggest fracture. There are mild discogenic endplate changes at L5-S1.

Spinal Cord: Inferior tip of conus is at L1-L2 level. Imaged spinal cord has normal morphology nd signal intensity. There is no evidence of spinal cord impingement or other cord pathology. Cauda equina and filum terminale are normal.

General degenerative changes: There is multilevel disc dessication.

L1-L2: There is no significant disc displacement, disc-osteophyte, spinal canal stenosis or neural foraminal narrowing. There is mild bilateral facet hypertrophy and ligamentum flavum hypertrophy.

L2-L3: There is a mild circumferential disc bulge. There is mild bilateral facet hypertrophy and ligamentum flavum hypertrophy. There is minal spinal canal stenosis. There is no significant neural foraminal narrowing.

L3-L4 : There is a mild circumferential disc bulge. There is bilateral facet hypertrophy and ligamentum flavum hypertrophy. Together these findings result in mild canal stenosis. There is mild bilateral neural foraminal narrowing.

L4-L5: There is a mild circumferential disc bulge. There is bilateral facet hypertrophy and ligamentum flavum hypertrophy. Together these findings result in mild canal stenosis. There is mild bilateral neural foraminal narrowing.

L5-S1: There is a mild circumferential disc bulge. There is mild bilateral facet hypertrophy and ligamentum flavum hypertrophy. These findings result in mild bilateral neural foraminal narrowing. There is no significant canal stenosis.

Additional observations: The imaged extraspinal structures are normal.

Impression: Multilevel degenerative disc disease and facet arthrosis resulting in moderate canal stenosis at L3-L4 and mild canal stenosis at L2-L3 and L4-L5. Mild bilateral forminal narrowing at L3-L4, L4-L5 and L5-S1.

Now, I am no doctor, but I am seeing a lot of "mild mild mild" and yet, he is wheelchair bound and cannot stand for more than a few seconds before the pain comes and he has to sit. He can twist he legs, bend his feet, wiggle his toes but cannot lift his thigh of the seat more than a few inches. I am confused, he is confused, and I guess we don't feel so bad since some doctors are confused. Any help or advice is appreciated.

Thanks in advance.

No one on the Spine-Health patient forums is medically qualified to provide any advice or recommendations on any diagnostic test. However, the following key words can always be applied.

  • MILD Treated with conservative measures such as Physical Therapy and mild medications. Many times these situations can be cleared up and the condition can be resolved.
    MODERATE Some more treatments may be needed, ie Spinal Injections, Ultra sound and stronger medications. Always a possibility of more aggressive treatment if the conservative measures don't help
    SEVERE Need for stronger medications. The requirement for surgery may be necessary



  • LizLiz Posts: 7,832
    edited 11/20/2015 - 9:44 PM
    Please take the time to read this post and refer to it when you have questions

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    Liz -Spine-health Moderator

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • LauralauraLLauralaura Posts: 27
    edited 11/22/2015 - 5:40 AM
    I am sorry to hear of such a diminshed quality of life (walking to wheelchair), in anyone. Would seem you need a neurosurgeon and orthopedic specialist, who does spine surgery to assess your dad. Reading and MRI report and relating it to symptoms and weaknesses is the job of the specialists. The weight issue is a problem(as well as any other health issues) if it is obesity, as this complicates recovery from any surgery or success with pt, etc...

    Best of luck to you and your Dad.

    Please seek this help for your Dad and don't give up without 2nd opinions from qualified specialists in your area. They should be able to give you the answers and direction that you need to go in next.
  • MarybogieMMarybogie Posts: 20
    edited 11/23/2015 - 2:14 AM
    Has he had any physical therapy? His age and his size are big risk factors, add in immobility and he's in[edit] trouble. I didn't see anything in your post that would warrant surgery. He [edit] get moving.
  • Thanks for the replies. He was doing physical therapy in the rehab facility. However, the pain he would experience when trying to stand was a roadblock. The therapist said he would need to get rid of that pain or otherwise they would just be spinning his wheels but not going anywhere. Basically I just wanted to see if anyone had a similar situation - the MRI doesnt match up with his symptoms and its confusing the doctors that look at it. Could spinal stenosis cause him to be wheelchair bound even though it shows as mild on the MRI?

    We are looking for another neurologist right now. Thanks for the replies again all.
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