When do you say "ENOUGH"
For 28 years, Specialists have had their chances with the promise they would always be here for support and "OLD SCHOOL" help with pain. Is this much damage uncommon??I didn't drink, smoke, do drugs, etc. when I was injured in 1984. but now pain meds are what almost get me comfortable. The surgeons have had their chance, when do we stop being stigmatized and get treated without the threat of being catergorized as addicts? I have tried everything. Mike
Relevant History, Increased Back Pain Prior to surgery
History; Increased back pain, prior surgery. CT Scan of the thoracic and lumbar spine w/contrast 3/8/2013 @ 1441.
CT Scan of the thoracic spine w/contrast 3/8/2013 @ 1441.
The Vertebral body heights and alignment appear grossly well-maintained within the Thoracic spine. There is some degenerative disc desease with small anterior osteophytes at T2-T3. There is also vacuum disc phenomenon T9-T10, T10-T11, T11-T12, T12-L1. No significant annular bulges are appreciated on this exam. Small Schmorl’s nodes are seen within the superior endplates at T11 and T12. There appears to be mild central canal narrowing at T10-T11 and T11-T12 secondary to bilateral neuroforaminal narrowing at T10-T12 and T11-T12 secondary to facet joint arthropathy. There is a stimulator lead within the posterior aspect of the central canal extending from T7 inferior endplate to the T8 inferior endplate.
The paraspinal soft tissues appear unremarkable. No abnormal enhancement is seen involving the spine.
1. THERE IS MILD CENTRAL CANAL NARROWING AT T10-T11; AND T11-T12 AS WELL AS MODERATE BILATERAL NEUROFORAMINAL NARROWING AT TT10-T11 AND T11-T12 SECONDARY TO BILATERIAL FACET JOINT ARTHROPATHY AT THIS LEVEL.
2. THERE IS MULTILEVEL DEGENERATIVE DESEASE WITH VACUUM DISC PHENOMENA EXTENDING FROM T9-T10 THROUGH T12-L1. NO SIGNIFICANT ANNULAR BULGE IS APPRECIATED IN THE THORACIC SPINE ON THIS UNENHANCED EXAM.
Page 1 signed Report (continued)
Intravenously, axial CT images were obtained through the lumber spine down to the level of the distal sacrum. Coronal and sagittal reconstructed images were created for final interpretation.
The vertebral body heights and alignment grossly well-maintained within the lumbar spine. There has been previous posterior fusion from L3 through S1 on the right and from L3 through S4 on the left with interbody fusions present at L3-L4, L4-L5, and L5-S1. Otherwise, the vertebral body heights and alignment appear well-maintained within the lumbar spine.
At L1-L2, there is facet joint arthropathy and ligamentum flavum thickening producing mild central canal narrowing. There is mild right-sided neuroforaminal narrowing at L1-L2.
At L2-L3, there has been previous discectomy and interbody fusion. No significant central canal narrowing is seen. There has been posterior decompression from laminectomies at this level. Posterior fusion hardware is also in place at this level as described above. There is facet joint arthropathy and there appears to be moderate right and mild left neuroforaminal narrowing.
At L4-L5, there has been previous discectomy and interbody fusion. Posterior decompression from laminectomies has also been performed at this level. Posterior fusion hardware is also in place as described above. There is facet joint arthropathy with what appears to be minimal bilateral neuroforaminal narrowing.
At L5-S1, there has been previous discectomy and interbody fusion. There is also posterior fusion hardware on the right as described above. There is PROMINENT FACET JOINT ARTHROPATHY with what APPEARS TO BE MILD LEFT-SIDED NEUROFORAMINAL STENOSIS.
The paraspinal soft tissues appear unremarkable. No abnormal enhancement is seen within the spine.
Page 2 signed report (continued)
Relevant history: Increased back pain prior to surgery (continued)
1. STATUS POST SPINAL FUSION FROM L3 THROUGH S1 WITH EVIDENCE OF PREVIOUS DISCECTOMY AND INTERBODY FUSION DEVICES L3-L4,L4-L5, AND L5-S1. THERE IS POSTERIOR FUSION HARDWARE WITH PEDICLE SCREWS AND RODS EXTENDING FROM L3 THROUGH S1 ON THE RIGHT AND FROM L3 THROUGH S4 ON THE LEFT.
2. MILD CENTRAL CANAL NARROWING AT L1-L2 SECONDARY TO FACET JOINT ARTHROPATHY AND LIGAMENTUM FLAVUM THICKENING. MILD RIGHT-SIDED NEUROFORAMINAL NARROWING ALSO APPEARS TO BE PRESENT AT L1-L2.
3. FACET JOINT ARTHROPATHY PRODUCING RIGHT AND MILD LEFT NEURAL FORAMINAL NARROWING AT L3-L4, MINIMAL BILATERAL NEUROFORAMINAL NARROWING AT L4-L5 AND MILD LEFT SIDED NEUROFORAMINAL NARROWING AT L5-S1.