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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Spinal Stenosis

Hi Thank you for answering my question. I had 11 back fusions due to scoliosis. Severe stenosis at L4-5. There is scoliotic deformaties with the apex seen at T2-3. At C5-C6 there is a mild to moderate generalized disc bulge. There is a borderline central canal stenosis caused by a mild generalized disc ridge complex. Aggregation of most of nerve roots on the right side o fthe thecal sac at L1-L3 and L3-L4 probably due to scoliotic tilt. Differential, for the finding includes arachnoiditis, however a few nerve roots are seen floating in the thecal sac at both levels. All of the former information was taken from a report from 2013. All of the following information was taken from a report from 2016. I also have prominent facet arthritis results in minimal spondylolisthesis, bulging of the annulus at L4-5, severe spinal stenosis and right lateral recess stenosis. In addition I have moderate right foraminal stenosis is also noted, mild degenerative bulging of the annulus and facet arthritis at L5-S1. Narrowing of the spinal canal remains minimal but at least but at least moderate bilateral foraminal stenosis is suspeceted. No significant spinal stenosis at the upper lumbar disc levels, no intrathecal abnorm abnormality. The conus is normal in contour. No significant bone marrow abnormality. I always have pain and I am not able to stand up straight. I occasionaly go to an orthopediac surgeon to access me to see if I am ready to do the surgery for the stenosis. Since I already have 11 fusions the doctor is concerned about my ability to walk since the surgery requires additional fusions. My flexibility is limited now and apparently walking requires a certain amount of flexibility that I may not have after additional fusions. Just recently my pain has increased, I assume from over use. Today the pain level was very high and my hands began to shake after I stood up for short periods of time. The shaking was associated with high pain level. I also seemed to loose a small amount of co-ordination and also got slightly dizzy at times. My question is do you think the shaking and the co-ordination and dizziness are caused by something impinging on the spine or a result of the extreme pain. Tonight my blood pressure was 155/80. Normal pressure is about 128/80. I often get high blood pressure associated with high pain. This pressure is not as bad as it can get especially with pain for long periods. I gave a long explaination of my condition so that you can better judge if any of the problems I have with my spine have the potential to put pressure on my spine as I am not sure if shaking of hands is caused by pressure on my spine or pain.
Mon, 12 Nov 2018
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General Surgeon 's  Response
Hello,

Consult a neurosurgeon and get evaluated. If conservative management fails, surgical correction may be required.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Shinas Hussain, General & Family Physician
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Suggest Treatment For Spinal Stenosis

Hello, Consult a neurosurgeon and get evaluated. If conservative management fails, surgical correction may be required. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician