When is surgery required?
My name is Dominic and I was a workaholic...
Now at the age of 43, I am unable to work. Today my greatest physical accomplishments are light household tasks. I have had issues with my neck and back for several years now unfortunately everything came to a crashing halt on June 23, 2011. My G.P would not request any sort of imaging and just chalked my symtoms to muscle spasms, Fibromyalgia and chronic pain. When imaging was requested these were the findings:
X-RAY of the Lumbar Spine
-end plate entophytes are present at multiple levels in the Lumbar and lower Thoracic Spine
C.T of the Lumbar Spine
T12-L1-there are small end-plate entophytes and there is mild bilateral facet osteoarthritis
L1-L2-there are end-plate entophytes and there is mild bilateral osteoarthritis. There is a slight bulging of the disc
L2-L3-there is a far right disc protrusion, disc material extending into the intervertebral foramen along the exciting L2 nerve root. There are end plate entophytes. There is mild narrowing of the interverterbral foramen bilaterally
L3-L4-there are end plate entophytes and there is bilateral facet osteoarthritis. There is mild narrowing of the intervertebral foramina bilaterally. There is a bulging of the disc and there is mild bilateral ligament flavum hypertrophy. There is mild central spinal stenosis.
L4-L5-there are end plate entophytes and there is bilateral facet osteoarthritis. There is a mild narrowing of the intervertebral foramina bilaterally. There is bulging of the disc, and there seems to be a left sided disc protrusion. There is borderline central spinal stenosis.
L5-S1-there are end plate entophytes and there is bilateral facet osteoarthritis. There is mild narrowing of the intervertebral foramina bilaterally and there is a mild bulging of the disc.
MRI Of the Lumbar Spine
L2-L3-There is a right far lateral disc extrusion with some extension into the inferior foramen bilaterally. More so on the right with possible impingement upon the exiting L2 nerve root.
L3-L4-There is decreased signal intensity and disc height with a broad based protrusion measuring several millimetres flattening the ventral thecal sac. This extends into the far lateral region bilaterally and there is a mild degree of bilateral foramina stenosis. I suspect possible impingement on the exiting L3 nerve root.
L4-L5-There is a decreased signal intensity and disc height with a broad based disc extrusion flattening the ventral thecal sac. There is a focus of increased signal intensity in the dorsal disc margin which may represent a fissure in the annulus. The broad based bulge does abut the L5 nerve roots in the lateral recesses , more so on the left with likely impingement upon the descending L5 nerve root against the posterior bony canal wall.
L5-S1- There is a decreased disc in height and signal intensity.
A broad based disc extrusion is noted posteriorly near the mid line flattening the ventral thecal sac causing a mild degree of left sided foramina stenosis. There is likely impingement upon the exiting L5 nerve root.
MRI of the Thoracic Spine
A minor disc bulge is noted at the T8-T9. This appears no compressive.
A further disc bulge is noted at the T11-T12. This also appears non compressive on the sagittal sequences.
*** Please note***
In desperation I have done some inquiry in out of country surgery with a no cost image consultation. Their findings (North American Spine)
In the Lumbar Spine their findings correlate with the imaging performed at Northumberland Hills Hospital, however….
Spinal cord compression due to multiple bulges.
My symptoms presently:
-range of motion affected in the neck
-neck pain at times intense numbness, stinging and tingling spreading into shoulders, down arms and into hands
-off and on numb pain affecting grip strength in hands more so left side
-vertical crushing middle back pain, intense numbness, stinging and tingling
-rib cage pain (crushing) front and back at times affecting breathing
-at times intense lumbar pain affecting range of motion, pain traveling across upper buttocks into abdomen, leg fold
-horizontal abdominal pain (dull surge pain)
-rectum pressure traveling in between rectum and testicles , at times intense lasting several days at a time
-hip and upper leg fold pain (intense stinging, sensitivity and numbness) travelling to pubic bone area
-upper thigh pain (dull surge pain) travelling down to knees, more so right side.
-fairly consistent outside (bi-laterally) shin pain (dull sting) traveling across top of feet with occasional stinging tingling on the bottom of the feet
-more recently occasional back of the knees and calves dull stinging pain traveling to ankles affecting foot range of motion at times.
-cold wet feeling in shins traveling into feet
-past and present Physiotherapy (which currently, I am paying)
-Apo-Tramadol/Acet 37.5/ 325mg 1 tablet 3 times a day
-Pms-Baclofen 10mg 1tablet 4 times a day
-Pms-Gabapentin 300mg 3 capsules 3 times a day
-Arthrotec 75 75mg 1 tablet 2 times a day
To date my G.P has not sent out a successful request on my behalf. I believe that the reason for that is not only is he incompetent but may possess a God Like Complex...I collapsed back in February 2012. I was taken to a local hospital and subsequently a referral to a Surgeon in Kingston was made for me by the attending Doctor. During the appointment I was observed only by the Surgeons student. The student exited and entered the examining room on three different occasions gathering tid bits of information. On the third entry by the student, I was advised that Dr. Yen is very specific on who he operates on. My examination consisted of the removal of my socks only, and some reflexology. When the Doctor finally entered the room he quickly escorted my wife and I to another room. He should us on the screen of a laptop an obscured sagittal view, the imaging was entirely greyed out. He pointed at the image on the screen and said you have a normal spine for someone your age. When I asked him to show me a clear sequence of my spine or perhaps an axial view of spinal cord compression he beacame rather agitated. The Dr. told us that 50 % of my fellow workers have a back like mine. He stated "what now you have Thoracic problems"? I replied, did you not go over my symptoms with your student, did you not look at the imaging on disc that I have brought in today? He slid back in his chair crossed his arms and asked me "what disc would you like for me to operate on"? At that point if I was dying I still would of walked out the room. Can anyone provide me with any kind of direction as I do not know what to do anymore...
Hope may be the greatest measure of survival.