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Back Problems Message Board

Back Problems Board Index

Welcome to the board. I would suggest that you might also want to make an appointment with an orthopedic spine surgeon for a "second" opinion. Their training is similar to a neurosurgeon, but sometimes they approach problems differently. You have a problem that is less common than some, and you will want to confirm whatever the first surgeon suggests to you. Since it can take many weeks to get in for that first consultation, I would suggest you make the appointment now.

I read the comments on the other board, and I would concur that the congenital narrowing of the central canal can be, and most likely is a pain generator for you. The spinal cord stops at about the L1 level on most people. After this point, the spinal nerves come off each vertebral segment and come together to form a bundle of nerves, called the cauda equina, that run the rest of the way down your lumbar and sacral spine. When the canal is smaller than it should be, it can cause problems...particularly if there is anything else impinging on this space. The result is that one or more spinal nerves end up being compressed, which can result in the nerve pain that radiates out from the spine to the limbs, depending on what level the nerve is compressed.

Usually when you have numbness or tingling in the arms or hands, it is from cervical issues. (Symptoms from nerve compression run from top down -- in other words, there can be pain from a cervical nerve irritation or compression from the level of the nerve cervical nerves could cause pain in legs or feet, but they do not run a lumbar nerve compression will not cause pain in your shoulder or arm....

I would agree that your biggest problem is the narrowing of the central canal at the L4-L5 segment. 3.5 is a very small measurement. This causes stenosis, which is a narrowing. Stenotic pain is often situational--for example, it will hurt more when you are standing or walking and feel better when you are leaning forward. I would imagine that the only way you will be able to decompress the nerves is through surgery. They will go in and clean out everything that is impinging on the canal, so there will be more room for the nerves...a "roto-rooter" procedure for the lumbar spine.

There are a number of other, smaller issues that may or may not need to be addressed as well. The MRI results will need to be correlated with the results of a physical exam, a basic neurological exam and an oral history before the doctor will know the significance of the findings from the MRI.

Given your sister's history and other family members' problems, you probably need to have imaging done on the rest of your spine, so the specialist has a complete picture of what may be going on.

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