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DDD + severe recess and foraminal stenosis = surgery?

wacommewwacomme Posts: 1
edited 06/11/2012 - 8:57 AM in Spinal Stenosis
Ok. I just found this forum and I haven't searched through it yet. I have an appointment with a spine specialist on Tuesday and I'm anxious.

My RMI shows:

1) Moderate to severe DDD at L2-3
2) grade 1 retrolisthesis measuring 3mm at L2-3
3) severe R lateral recess stenosis and severe R neuro formaninal stenosis
4) Mild DDD at L3-5
5) Posterior disc bulge at L5-S1 with severe extension into inferior aspect of L neural foramen
6) AP dimension of thecal sac is 1.3 cm at L5-S1
7) Severe left lateral recess stenosis and very severe left neural foraminal stenosis with complete effacement of neural foramen.

I'm a 50 year-old competitive cyclist. The ortho doc before the spinal specialist referral said not to participate in impact sports such as running (I was training for a marathon in December during the off-season of bicycle racing).

Pain is with me constantly - lower back and right hip. I've had the paid for at least 2-3 years and it's getting worse. I don't have pain down the legs, nor numbness or muscle weakness; perhaps I have very slight numbness in my feet.

I'm scared. The MRI result was a complete surprise to me. With the severity of my MRI results, what options do I have? Are nonsurgical interventions of any use? I'm concerned about nerve damage. Need I wait to have shooting leg pain and/or numbness for surgical intervention? With complete effacement of the neural foramen at L5-S1, can this condition improve with nonsurgical treatment? Is there a problem leaving the severe stenosis "as is" without surgery? What problems can ensue without surgical intervention?

Also, with the severity of my condition, will I be able to return to competitive cycling? If I need fusion, will this interfere with the bent-over position on my bicycle? Is it better to just live with the pain? I currently take ibuprofen from time to time. And while I don't currently participate in physical therapy, I use yoga for flexibility and weight training for core strength - will actual PT do much more for me? I'm also concerned that if I go the steroid injection route, while perhaps helpful for pain, the procedure will do nothing for my stenosis and resulting potential nerve damage over time.

I certainly will seek second and third doctor opinions after my appointment with the spinal surgeon on Tuesday. However, I'm trying to gather as much information as possible to access my situation and treatment options. I would appreciate any thoughts and opinions you may have.

Thank you.
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Comments

  • Hey there, welcome to Spine-Health. I am so sorry you' ve got spine trouble. You have found a wonderful site. There is so much to learn and this site is so helpful. Your appointment with your spine specialist will help you very soon. As a member of this site we are here for you. Although we can't help you with your MRI, we are here to gave you support. One thing I've learned, when dealing with my spine issues, educate and be your own advocate. Take care and I hope you get the answers you need soon!
  • Sorry to hear this has affected your training and anything severe will be checked out with an Ortho or Neurosurgeon. Check out in little blue box top of page, do a search for 'questions to ask the Surgeon' and http://www.spine-health.com/treatment/back-surgery/specific-questions-ask-your-spine-surgeon

    Ask him if there's instability there and if you need surgery. We're not able to read MRI but hope the Surgeon will help you Tuesday. Maybe write a journal about your numb feet and if your leg feels like it will give out and any other symptoms and if anything makes it worse like standing for too long or sitting. Keep us posted.. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • I'm now 56 years old. I was 50 when I made my posting. I've lived with back pain for the past 6+ years, sans surgery. It's not terrible. I've continued to race my bicycle. Long sustained climbs hurt my lower back, but I've managed. I've also worked on core at the gym and stretching, including yoga. The core and stretching have helped relieve the pain. 

    However, I now have a numb left foot. This started after my second hip labral surgical replacement. For the past 2-3 years my hip pain has gotten worse and worse. It turned out that I had a disintegrated labrum in both hips. So, instead of hip replacements, I opted for labral reconstruction - a fake labrum constructed from cadaver facia. Some cartilage damage was also repaired. The surgeries require 6 weeks on crutches. I had my right hip surgery in January, and my left hip done in April. It's a little over 3 week post-op with no weight bearing on my left leg. Just after my left hip surgery I noticed my left foot going numb - ball of foot and toes. This was intermittent at first, but for the past week the foot has been numb. There's a little tingling when move a lot, but sitting or standing still (common on crutches), the foot is numb. My surgeon told be a week ago to contact him again if the condition continued for a week. I'll contact him Monday. He thinks it's related to my lower back and the position I'm in using crutches. I tend to agree. Except for the surgery itself, the only change is that I'm now leading a sedentary lifestyle - complete opposite to my normal lifestyle. I'm sitting and lying around a lot, with limited movement (PT). 

    I tend to think once I can start placing weight on my left leg (6 days from now), and especially when I'm off crutches (3 weeks), the numbness will go away. But I don't know. 

    Should I make an appointment with a spine surgeon? Is another MRI needed? Should I just wait and see what happens to my foot when I'm off crutches? Has my spine worsened? I'm now nervous again about my lower back. Ugh. 


    Michael

  • Michael, of course you need another MRI!  You need to know what is causing the problem!  Good luck, and please keep us advised!  Cathee

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