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  1. #1

    what can I do?

    My MRI conclusion: "Discogenic degeneration at L1-l2, L3-L4, L4-L5 and L5,S1. Moderate sized broadbased posterocentral disk protrusion at L4-L5 with moderate to severe spinal stenosis and mild bilateral foraminal stenosis..Mild spinal stenosis at L5-S1with mild foraminal narrowing." PT & excercise (bending) make my lower back hurt worse - spinal shots scheduled, but didn't help in my neck, standing or walking turn my leg from spine all the way down the back of my leg into a terrible painful weak mess & I fall a lot now. My PCP says she doesn't think surgery is the answer, wants to go conservative - this's been going on since April 15, when I broke 5 ribs & hurt my back in a bike accident - pain meds don't even dull it - what can I do? I don't even know what 1/2 of this all means, except that I hurt across my hips & down my leg - Any suggestions?

  2. #2
    Go see a specialist ASAP. I've found that PCPs have no clue when it comes to sci.

    Good luck.

    Hopefully one of the nurses will chime in soon.
    Ugh, I've been kissed by a dog!
    Get some hot water, get some iodine ...
    -- Lucy VanPelt

  3. #3
    It does not appear that the OP has a spinal cord injury, but instead has significant spinal (not cord) problems.

    I would agree that she should see at least two specialists to get opinions about surgery, but with the understanding that spinal surgery for these types of conditions often does not relieve pain, and is generally only done to try to prevent or treat actual neurologic deficit (such as weakness, loss of sensation, or bowel/bladder problems). The surgeries themselves can cause cord damage as well. A neurosurgeon and a spinal orthopedic specialist would be good choices for the two opinions.

    (KLD)

  4. #4

    ok, what now? I'm confused

    I had an injection in the lowest part of my spine, down at the tailbone (I think she called it a caudle) and it helped with my back pain, but didn't help with the leg pain & such - now (last couple of weeks) having some problems realizing when I 'need to go' and have started (unfortunatly) wearing adult diapers to prevent accidents. The doctor said I have disks pressing into my column close to the cord, that there's a tear in something (again, confused) and the nerves are also pinched, that this (the injection) wasn't a 'cure' but a 'bandaide' and to be very careful bending, not to twist, not stand for long or walk unless I have to ....
    I'm confused on what to do, how to proceede. I guess my problem isn't really an SCI, but what is it?

  5. #5
    Quote Originally Posted by Rev Coleen View Post
    I had an injection in the lowest part of my spine, down at the tailbone (I think she called it a caudle)
    Sacrum?? Coccyx?? what bony levels? It should been included in your consent (check this document). What was injected?

    It helped with my back pain, but didn't help with the leg pain & such - now (last couple of weeks) having some problems realizing when I 'need to go' and have started (unfortunatly) wearing adult diapers to prevent accidents.
    Have you discussed self intermittent catheterization with your doctor? Seen a good urologist? Had urodynamics testing?

    doctor said I have disks pressing into my column close to the cord, that there's a tear in something (again, confused) and the nerves are also pinched, that this (the injection) wasn't a 'cure' but a 'bandaide' and to be very careful bending, not to twist, not stand for long or walk unless I have to ....
    A dural tear or a disk tear? If so, where? From what? Pressing into your spinal canal I suspect, not the column (bone) which would not cause you problems. If it is low, you probably have a cauda equina injury. The cauda equina is made up of the peripheral nerves that come off the spinal cord in the lower lumbar and sacral areas. Damage here will generally cause bowel, bladder and sexual dysfunction, and may cause weakness in the ankles and lower legs as well.


    I'm confused on what to do, how to proceede. I guess my problem isn't really an SCI, but what is it?
    First, you need to see this doctor again and don't leave their office until they explain this to your satisfaction, in language you can understand, with diagrams, etc. Is this a neurologist or what is their specialty?

    Then you need to request a referral to a good neurosurgeon for an evaluation to see if anything can be done surgically (and if your doctor is already a neurosurgeon, to someone else for a second opinion) and then to a physiatrist and a good neurologic urologist.

    (KLD)

  6. #6
    I believe the coccyx was the injection site - really low down where the tailbone starts. It's the "right aspect of the L-2 vertibral body extending to the right pedicle..." and the problems are inabibilty to always know when I have to BM, leg weakness & pain going from my just above tailbone, I seem to have to uninate all the time. The doctor doing the injection said something about the cauda equina, but I didn't understand it. I just hurt & needed some kind of relief. And how big is the spinal canal supposed to be? Mine is 11mm at one point, 9mm at another & 6 at another. I see a counselor, am a type 2 diabetic, which could have something to do with the need to urinate a lot, but the urgency or lack there of is new. The doctor doing the injections does just that now, it's her practice, and I don't know what any other speciality she has is. My PCP is the one 'in charge' of all of this - she's a ARNP & I've known her for 16 years. She was wrong about my neck, though, and had a back surgery herslf with some kind of not good complications - I think she might be afraid of the same for me.
    Last edited by Coleen; 07-18-2009 at 04:01 PM.

  7. #7
    Quote Originally Posted by Rev Coleen View Post
    I believe the coccyx was the injection site - really low down where the tailbone starts. It's the "right aspect of the L-2 vertibral body extending to the right pedicle..."
    L stands for lumbar, so your injection was done at the L2-3 space? That is at the tip of the spinal cord where the cauda equina starts. It is right about your waist line, not at your tailbone.

    I seem to have to uninate all the time.
    Which is why you need to see a urologist as soon as possible and get evaluated for a neurogenic bladder with urodynamics and a residual urine test.

    And how big is the spinal canal supposed to be? Mine is 11mm at one point, 9mm at another & 6 at another.
    The width of the spinal cord varies according to the segment of the cord you are describing.

    The doctor doing the injections does just that now, it's her practice, and I don't know what any other speciality she has is.
    You are seeing a physician and letting them treat you without knowing what their board certification is in? This is foolish. You should call the office first thing Monday morning and find out. Don't get more injections until you find this out, and I would still want a second opinion if the injections are not helping. If she is not an anesthesiologist, a physiatrist, a neurologist, or a neurosurgeon, you need to see one of those specialists.

    My PCP is the one 'in charge' of all of this - she's a ARNP & I've known her for 16 years. She was wrong about my neck, though, and had a back surgery herslf with some kind of not good complications - I think she might be afraid of the same for me.
    I am an advanced practice nurse too, and managing this type of problem all by herself without referring you to expert physicians is not appropriate practice for a nurse practitioner. Ask her to refer you to the specialists above, plus a urologist. NOW.

    Surgical treatment may not change your pain...in fact it is possible that treatment would make it worse. The goal of treatment should be to prevent any further neurologic deterioration. If you act quickly, it may not be too late to regain your bowel and bladder function. If it is too late, interventions should be taken if appropriate to keep them from getting worse (and yes, that is possible).

    (KLD)

  8. #8
    Quote Originally Posted by SCI-Nurse View Post
    First, you need to see this doctor again and don't leave their office until they explain this to your satisfaction, in language you can understand, with diagrams, etc. Is this a neurologist or what is their specialty?

    Then you need to request a referral to a good neurosurgeon for an evaluation to see if anything can be done surgically (and if your doctor is already a neurosurgeon, to someone else for a second opinion) and then to a physiatrist and a good neurologic urologist.

    (KLD)
    That's good advice. Consult with a neurologist and get a referral to a neurosurgeon to see what your options are. Please don't wait. Waiting can cause permanent damage.
    Daniel

  9. #9
    Rev, I don't know why you are getting all huffy. You need to read, and learn about your body and condition. If you don't take charge of the condition and your treatment, no one else will.

    Also, it is not considered cool to edit out your posts here after they have been responded to by others....

    (KLD)

  10. #10
    Sorry, didn't mean to be huffy, just gun shy. I also didn't relize I was editing a post or whatever. My bad.

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