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Forum Name: Spinal problems and back pain

Question: Confused about my back


 godolphins1985 - Mon Feb 06, 2006 4:50 pm

I am 20 years old and have gotten a back injury. I hurt my back in october of 2005. I had gone to the doctors that supplied medication for a back strain with bed rest. After a while of bed rest i returned to the doctors with zero improvements. The doctor made me go to physical therapy for 4 weeks 3 days a week. I attended PT with no luck, the Physical therapist couldnt figure out how to help me. After PT they sent me for a MRI, the MRI Report found numerous problems including: 2mm anterolisthesis, with bilateral pars defects. Biforaminal stenosis at L5 impinging the nerve roots. mild broad based disc bulge. Mild disc bulge with chronic focal extrusion at L4-5. After the report my doctor recommened me to a neurosurgeon. After seeing him he thought that i was having muscle problems and not nerve problems, he recommened more PT. I attended PT for another 4 weeks with no help and more pain. At the different PT place they also had problems helping my problem, the symptoms seemed to worsen each and everyday. During my last week of PT i started getting pain that would not allow me to even walk, this lasted 2 days straight. I went back to my neurosurgeon for my follow up the following day. He told me that surgery couldnt fix my back or the type of injections he had, so he is sending me to see a physiatrist to try to help. He said this was the last thing he can do for me. Can someone please help me in figuring out what in the world can be done to help fix my problem...medication has Zero affect on the pain or keeping the spasms down...ive had over 15 different types of meds now...PLEASE HELP ME =)
 Dr. Safaa Mahmoud - Tue Aug 08, 2006 12:13 pm

User avatar Dear godolphins1985,

From the report of the MRI it seems that the only lesion that is more likely to cause nerve compression is the forminal stenosis.
Symptoms of foraminal stenosis include:
numbness, weakness, and sensations of burning, tingling in the extremities supplied by the affected nerve.

They should be treated to avoid sensory or motor loss.

Doctors usually start with conservative and medical therapy. Improvement is expected within 6 weeks of regular treatment as the majority of cases have the pain due to the associated muscle spasm and weakness.
If these measure are unsuccessful , surgery- foraminotomy is considered for decompression.

It is not clear for me why your doctor excluded surgical interference. I am not a neurosurgeon, but you can discuss with him.

But, instability of the spine occurs in cases of spondylolisthesis., the neurosurgeon can determine whether , a spinal fusion should be added to decompression to stabilize the spine. You can discuss this possibility also.

Regarding the other lesions showed by the MRI as far as reported , they did not touch the nerves or caused nerve compression. However direct evaluation is essential.

I advise you to follow up with the consultant and to discuss with him this information.

Hope you find this information useful.
Best regards,

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