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What does " marked compresssion.of central and left thecal sac" indicate? - Online Doctor Chats

Date : 12-Apr-2014
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1504 Questions
User:I paid some money for a chat,25 but not sure how to.get there.i have l4extrisipn causimg marked compresssion.of central and left thecal sac with compressipn traversing the nerve root. Will an injection help this or do I need surgery?also an osteophute complex indending thecal.sac
Doctor:Hello
Doctor:Welcome
User:Had laminectomy 1991.injections.2.years ago.chronic pain bit recently hurt it.doing.barely.anything.pain severe in.buttock.voes.down.leg,some.spasm
User:I am.concerned.it.says.marked compression of thecal sac.i am hoping an elidural.a.d a facet injection.will do.
Doctor:I can understand your pain and suffering
Doctor:Marked compression means it is quite severe
User:Bowels bladder ok
User:Id like.them to.stay.that way,lol
User:I am.an icu nurse
Doctor:I can understand
Doctor:Steroids will help reduce the pain for some time
User:Says.marked.compression central and.left.side thecal.sac left nerve.route.
Doctor:I mean steroid injections
Doctor:Yes
User:Got.through course of steroids.seeing anesthesua tomorrow.
Doctor:That means it is severe enough to cause major symptoms
Doctor:that is good idea
Doctor:Yes
User:My hope injections.will fix it
Doctor:After steroid injections, the next step would be to go for long acting local anesthetic injection
User:Havent had sciatica like.this in years.always was.right.some muscle.spasm
Doctor:Age, and our straight backs make things worse
User:Awesome, i hope it works.there is a little.osteolhyte onl 4.5 indenting.thecal.sac but i.think.that one.has.been.there
Doctor:Ultimately, surgery may be required if you want to preserve the bowel and bladder function
User:So far.bowel.bladder r fine
User:But now m a bit worried one bad move and....
Doctor:That is very good
User:I wanted to.go.back.to.work.next week but i.think injections.first.could i harm it worse?
Doctor:You can wait for a few more weeks or months
Doctor:No
Doctor:Injections wouldn't make it worse
User:Wait.for?
Doctor:actually injections are only a symptomatic relief
Doctor:they will not alter the disease at all
User:No,injections will help.i m wondering if one.bad move and i push that sac more
Doctor:wait for going for surgery
User:See.i was hoping.to.go.for injections,manage it.that way
Doctor:Injections will help reduce the symptoms only my dear
User:I do know thecal.sac involvement isnt good but maybe.injections.will shrink.it up.it is already dehydrated
Doctor:they will in no way make the sac smaller
Doctor:Injections will never shrink it
User:So.the injections.will help but if the mri reading is accurate i nest get my butt surgery
Doctor:Yes
User:They will stop pain so if i have no.bladder bowel then leave it.that word marked
Doctor:At one point you will need surgery
Doctor:Yes
Doctor:As long as you don't have bladder involvement, you can manage with injections
User:Sh*******i.wanted.to go back to icu after injections.m.tough.my back in Other spots is.shakey.
Doctor:but once you develop bowel and bladder symptoms, the only choice would be to go for the surgery
Doctor:I am sorry my dear
User:Dont have them.but the word marked.
User:Will injections decompress?
Doctor:being in healthcare field, you should know how important it is to keep yourself healthy first
Doctor:No, the injections will not decompress
User:being in the healthcare field you know we are the worst
Doctor:the injections will not reverse the disease process
Doctor:nor will they slow down the progression
Doctor:Yes, I have to agree on that with you
Doctor:we are the worst patients
User:So in.reality.the injections will belp but in your thoughts i will.need surgery in months.yes we r the worst patients:)
Doctor:Yes
User:Do u think if i can hack the pain.after torinjection do you think I will be able to work before the surgery? something before surgery
Doctor:Yes
Doctor:in due course of time in my opinion, you will need surgery
Doctor:you should be able to work after the injections
User:Ok.so bandaide with the injections and can wait.few for surgery.does peeing often count?
User:I am bummed
Doctor:Not really if it is winter
User:But im thinking if i know i need surgery,just get abguy and do it may
Doctor:Okay
Doctor:It is your call
User:Well may as well habe them deal with osesteophyte.
Doctor:Yes
User:So peeing often is not a symptom
User:But u r saying within.the year.
User:I dont like this.
Doctor:they would generally take out the osteophyte if they come across it
Doctor:I am sorry my dear
Doctor:I have to be honest with you
Doctor:that is my opinion
User:But it n a differnt spot,maybe leave ot alone
User:but it is in a different spot maybe I should leave it alone
User:European is what I'm telling is yes you need surgery within the next few months
Doctor:Yes
Doctor:if it is not coming in the way of the nerve then there is no point searching for it
Doctor:doesn't serve any purpose
User:wow that voice recognition did not work. I said what you are saying is Buttercup suck it up and you will need to do the surgery in a few months or sooner whatever you choose. But about that osteophyte being in a different location a different lamina, maybe I should leave that one alone its only indenting
User:it does in Penge on the nerve it said
Doctor:if it is impinging on the nerve then it is best to get it out as well
Doctor:even if it is in another lamina
User:well thank you for confirming what I already knew. But I wasn't sure if I was just being you know knowing a little too much, but you made me confirm what I was thinking.
Doctor:I know that you know
Doctor:I am doing my part here
Doctor:Is there anything else I can help you with?
Doctor:I hope I was able to help put things in perspective
Doctor:thank you for using the service
Doctor:Take care, and all the best for everything.
Doctor:Bye for now
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