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Spinal Cord Disorders Message Board


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Newbie here, hoping to get some coaching before my appointment with a neurosurgeon next week.

[B]Presenting symptoms:[/B] sharp, flashing, “sheets” of pain through both buttocks. Most unusual stuff I've ever experienced! Sharp pains in muscles at top of thighs, midway between the front and side of thigh. Weakness of the right leg, dull ache in right calf. My gait has gone wonky – I can't stride at all; I sort of waddle, like Popeye. I've fallen twice, once on a completely flat, unobstructed surface. I expect it's because I've spent six decades developing muscle memory for walking, and now what I expect of my legs isn't happening any longer.

[B]Diagnositcs:[/B]

GP ordered an xray and sent me to an ortho man in the provider group. The xray radiologist didn't see anything unusual, beyond what he characterized in the findings as “mild” bone spurring. The ortho man ordered an MRI.

In light of the MRI findings (which I don't begin to understand yet), I was disappointed in the ortho doc's plan going forward – essentially pain management and PT.

I've copied the MRI radiologist's findings below. I will see a neurosurgeon next week to discuss these findings. As this is an entirely new area of medicine for me, I'd be grateful for any coaching more experienced patients/caregivers could offer to me concerning issues, ideas, questions, etc. that I should raise with the neurosurgeon.

Honestly, I'm not eager for any kind of back surgery. On the other hand, I'm not eager to spend the residue of my life managing pain and advancing immobility IF those can be forestalled or avoided by surgical intervention now. My health is reasonably good now; in ten years, perhaps it won't be. Someone somewhere said “Carpe diem!” and I'm minded to consider that advice seriously.

So, what would you pester the neurosurgeon about? That business in the findings about a synovial cyst looks serious. But, I have no sense, really, for any of the findings – whether they're serious or not.

Anyone who's gone down this or similar paths, I'm all ears.

Here's the MRI findings/impression:


[I][B]Findings[/B]:

Vertebral body height are will-maintained. Scattered vertebral body hemangiomas, largest of which is anteriorly situated within the L3 vertebral body.

Decrease in expected lumbar lordosis. Background of congenitally narrowed spinal canal, most significant at the L1 level. Mild dextroconvex scoliotic curvature.

Multilevel disc space height loss greatest at the L4-L5 level asymmetric to the left, and less so at the T10-T11 level.

Conus is unremarkable in caliber and signal intensity and terminates at the upper L1 level.

T10-T11: Minimal disc bulge without spinal canal or neural foraminal stenosis.

L2-L3: Asymmetric left disc bulge with minimal bilateral neural foraminal stenosis. Mild congenital spinal canal stenosis.

L3-L4: Moderate ligamentum flavum hypertrophy and facet arthropathy with a circumferential disc bulge asymmetric to the right. Small superimposed foraminal disc protrusion with disc material that extends into the anterior-inferior aspect of the right neural foramina. The disc lies in near proximity to the exiting right L3 nerve root sleeve. 9x3 mm synovial cyst with asymmetric to the right disc bulge results in encroachment of the right subarticular recess and possible compression of the descending right L4 nerve root sleeve. Resultant mild to moderate spinal canal stenosis asymmetric to the right. Left neural foramen is widely patent.

L4-L5: Circumferential disc osteophyte complex with moderate left and mild right facet arthrosis. Superimposed millimetric inferior left foraminal disc protrusion results in mild left greater than right neural foraminal stenosis. There is also encroachment on the left subarticular recess.

L6-S1: Congenital spinal canal narrowing without notable stenosis or neural foraminal stenosis.

[B]Impression[/B]:

Multilevel/multifactorial lumbar spondylosis, greatest at the L3-L4 level, with a right facet joint synovial cyst that results in subarticular recess stenosis.[/I]





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