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Need Advice From People Who have been there !!

jovondaadamsjjovondaadams Posts: 6
edited 06/11/2012 - 8:43 AM in Lower Back Pain
OK this is going to be long so i am sorry...
My husband had a disk replacement last year workers comp.. well lawyer said medical was left open well come to find out its open for 3 years but we have to prove there has been a change in condition for the worse.. so we are on a mission.. we just paid out of pocket for the mri we have no insurance so we have no family doctor.. before we pay to go see a doctor that may or may not help us i would like to post his 2 mri reports the old and new and see if out of everyone here believe's there has been a change.. i know u guys are not doctors and all that legal stuff just person to person our beliefs..thanks and sorry this is so long.. here are the mri results...


June 23,2008

Findings: there is straighting of the normal lordosis that may reflect patient positioning or muscle spasm.

There is no loss of vertebral body height,fracture or subluxation and no marrow signal abnormality.

The imaged spinal cord and conus medullaris are unremarkable with the conus ending at L1

Disc Material
L1-2 There is a slight disiccation of disc material and minimal disc bulge without spinal or lateral recess stenosis

L2-3 normal

L3-4 normal

L4-5 There maybe a minimal disc bulge without spinal or lateral recess stenosis

L5-S1 There is a slight rigth paracentral disc bulge with minimal lateral recess encroachment, right greater then left. ap diameter of the spinal canal is 13 mm (this is where the disk replacement was done)



Mri 4-20-10

Findings: the conus medullaris terminates at L1 and appears normal. Normal cauda equina

Lumbar vertebral body height and alignment are maintained. Artifact from prior anterior fusion at L5-S1

L1-2 demostrates no central canal or neuroforminal stenosis

L2-3 demostrates no central canal or neuroforminal stenosis

L3-4 demostrates mild broad-based disc protrusion and moderate bilateral facet joint hypertrophy. no central canal and mild bilateral neuroforminal stenosis

L4-5 demostrates mild broad-based disc protrusion and moderate bilateral facet joint hypertrophy. no central canal and mild bilateral neuroforminal stenosis.

L5-S1 demostrates artifact from post surgical changes

Conclusion: Post surgical changes with artifact at L5-S1
Mild Lumbar Spondylosis



Ok there is both reports please give me any insight of what your beliefs or thought of the two reports mean..thanks
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Comments

  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    The new occurance of broad based disc protusion and bilateral fact hypertrophy at L3 - L5 would certainly be considered post surgical changes "as stated by the reading radiologist". I guess my question or point of contention is - would be that this IS what is considered "adjacent disk disease".

    I always thought - heard that this was exactlly why people what disk replacement instead of fusion.

    Kinda sounds like he had ADR but is developing problems with other disks.

    Things that make you go hummm?

    My one question "back" at cha is .... what is his pain level, other symptoms (numbness - weakness) mobility, etc. These are important in the overall status in considering ongoing disability.

    Respectfully,

    D
  • He has been in bad pain since before the surgery but as of late it has gotten alot worse.. To the point it hurts to breath.. He says it hurts more than it did the first time he hurt it.. I can tell thats the case cause he doesn't seem to walk upright anymore.. I knew things hurt before but as an outsider just watching you can see the pain..he also still has the sciatic pain going into the legs and knees he has been complaining of his legs starting to feel weaker....hope that answers some of your ? yes he did have a adr... what did ya mean by I always thought - heard that this was exactlly why people what disk replacement instead of fusion.. so to you does it seem as if the condition has gotten worse ?
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  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    Are what would lead me to say YES CERTAINLY ... unfortunately, I am not the adjudcator or insurance clerk or doc who will make that ultimate decision.

    Kudo's to you for being so supportative and concerned about his ongoing condition.

    To answer your ?? Many people tend to prefer ADR thinking that with the less reduced flexability of a solid fusion ... the incidence of adjacent disk disease is reduced. In your husbands case it would seem that the procedure has not stopped progression of facet arthropathy ... but I would tend to think he IS better off with an ADR. They are considered "the state of the art procedure" better than solid fusion.

    ADR was not an option for me as I had a failed 3 level ... then revised to 4 level. They don't do multi-level ADR here in the states - yet.

    Keep your frown - upside down!

    Regards,


    D

  • Thanks for your input.. It was greatly appriciated.. Now only to find a doctor who will even see him..has been the next issue we are dealing with..None that we have talked to or tried to make an appointment with whats to get involved...said they would look at the results and be more than happy to offer treatment "which we would have to pay for" but didn't think that even if it shows a change of condition they would or should write it out for the courts...so i dunno starting to feel helpless and mad... I had a acdf done in november I sure hope I do not get the run around on my medical the way he has !!
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