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GET THIS. OPINIONS PLEASE...

kyadog115kkyadog115 Posts: 266
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
Hi,
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 !
Thanks.
Paul
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134

Comments

  • 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.

    Frustrating.

    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*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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  • 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?
    Thanks
    paul
  • 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.

    Dave
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  • 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
  • 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
  • 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

    Paul
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