Is there a chance of paralysis?

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floridaback

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If I do not have surgery and my condition worsens, is there a chance of paralysis? Has anyone had this happen. I have a fear of being in a car accident and having to undergo emergency surgery too. Anyone out there who has had to have emergency surgery?

Condition: spondylolisthesis gr 2 at L5, S1 with facet arthropathy and mild encroachment on the neural foramina bilaterally and mild stenosis
 
Paralysis, given the condition you've described, is not likely. However if you have symptoms of pain you could end up with permanent nerve damage (varies based on what you are experiencing). If you get no relief from conservative measures like physical therapy then surgery may be a good alternative for you. Once a nerve is damaged for too long it can be hard (or impossible) for it to heal fully.
 
First of all there is no spinal chord at the lower lurabar levels. Now if it was your neck that is another story. So please try not to worry because I believe you have nothing to fear.
 
What do you know regarding damage to the nerves? I really do not have an understanding of this. What can be expected? Thank you!
 
Floridaback:

When a disc is herniated often it results in pressure put on a spinal nerve in the area. The area that one specific disc can affect is refered to as a dermatome - each level of the spine affects different areas. There are charts you can view that show what spinal level is associated with which part of the body (symptoms). So if you have a lurabar herniated disc it can't cause arm pain, that's not the path the nerve in the lurabar area takes.

For my back problem I was diagnosed with spondylolistheisis L5-S1 (anterior displacement of a vertebra in relation to the vertebra below). This caused pain that radiated into my right hip and down my leg (but not as much as typical sciatic pain).

Many people with herniated discs in the low back have pain that travels down a leg (sciatica). This can also be caused by any kind of impingement of the sciatic nerve (either by disc herniation, bone spurs, or other conditions that cause a nerve to be impinged). For those with neck disc problems the pain tenRAB to go down one or both arms. In my case, my neck problem caused radiating pain down my left hand. If you have any symptoms where you have pain that travels down a lirab it is commonly referred to as radiculopathy (nerve root impingement).

Using my neck as an example (since for me that is more recent) - I woke up one day with what I called a "pinched nerve" and pain that went down my arm. My general doc at the time was not good and only gave me pain meRAB. A few months later my husband was having his tonsils out and I guess I was sitting in the consultation with his doctor and rubbing my left arm. The ENT (ear nose throat) doc asked me if I was okay and I told him the brief rundown of the pain and other symptoms. Just from the symptoms alone this doctor, who was an ENT (and not in orthopedics, pain management, or anything close) said "I think you have cervical nerve impingement". He referred me to a new general practitioner who upon seeing me ordered an MRI immediately. That showed that I had herniated discs in my neck that were indeed impinging on the nerve root. He in turn sent me to an Orthopedic Spine Surgeon (OSS). One of the symptoms I had was some nurabness in my left pointer/trigger finger. Because I waited too long to have the surgery that alleviated the nerve impingement I did get pain relief but never regained all the feeling in my one finger tip.

So, the key for you is, what symptoms do you have, how long have you had them, and what does your doctor recommend.

Sometimes nerve symptoms improve over time with rest, changing your body mechanics, physical therapy, etc. But if the symptoms seem to be nerve related and don't get better with conservative measures then you have the chance that the nerve won't recover. Nerves heal slowly, at best, and if the impingement or damage lasts too long without surgery (or any other type of treatment) then the damage can be permanent.

Keep in mind that if you have spondylolisthesis and have no symptoms of pain, etc, then there is likely no reason to do surgery. If you took 100 people off the street who don't have any symptoms of low back or radiating pain, and gave each one an MRI, you'd likely find a few that have disc herniations or even spondylolisthesis that didn't even know it. It may be that the disc herniation or spondylolisthesis is not at a point where it is impinging the nerve - thus they wouldn't know they had the herniation or spondylolisthesis. It's not the diagnosis or MRI that are solely important - but what symptoms you have.

What symptoms led you to the results you mentioned? MRI?

And what type of doctors have you seen thus far and are you planning to see for this?

Karin
 
I have read that the longer a nerve is impinged the less likely it will recover fully and the less immediate relief you can get from surgery.

If a nerve is impinged/getting nerve pains for more than 6 months shows irritation and/or impingement, your chances lessen, and the longer it is the more chance you have of permanent damage. Some people acutally can get drop foot with nerve impingement also, where the muscles when they walk cannot lift the foot near the ankle, and other things like that. Its not a fun picture.

Emergency surgery is just that- emergency- unless you have problems urinating or holding your bowels, emergency surgery is unlikely, AND who would want a surgeon they DONT know, operating on THEIR SPINE- not me. I liked getting to know my surgeon, trusting him, and getting my surgery at my own pace scheduled and mentally ready for it.

If surgery has been brought up, it will be needed one way or the other, its just your choice how long you try to wait, and how long you are ruining the nerves to the point they can't recover. My nerve was impinged for 9 months total, I still have nerve pains, and am on neurontin (helps block the pains), doesnt do it 100% for me but, better than nothing. Only time will tell if the nerve will recover. I had surgery in October, reherniated immediately and no one knew nor understood why I was recovering so poorly, had another MRI 4 months later, nerve impingement and severe reherniation, and had a fusion 8 weeks ago.

I didn't CHOOSE to wait for surgery, its just how it wound up, and the nerve impinged so long. SO just gotta wait and see for me how much my nerve recovers, but the impingement is now gone so no ongoing damage, just residual damage thats got to try and heal.
 
I was diagnosed with this at the age of 16 and am now 54. I recently injured my back stepping off a high curb wrong. In the past I have had other injuries from car accidents and overuse. I requested an MRI from my primary because I wanted an up-t0-date assessment of my current condition. After obtaining those results I requested to see a doctor who could give me an unbiased opinion because I did not want to see someone who would automatically suggest that I needed surgery.....I have already been told this 20 years ago. I saw a physiatrist or sports medicine/rehab doctor who gave me pretty awful news and stated that I was at stage 2, which I have been, and that I absolutely needed surgery. I am now on the mend from my last injury thanks to rest and ice and moist heat but it has been weeks and my entire body is out of shape now from resting. I cannot go the surgery route I have decided because it would require me to take off of work (small company, no leave available) with a recovery time of 3-6 months from what I've been told and then physical therapy. At this point in time, I have no extra money to survive and cannot afford to lose a job that is now just hanging in there. I do have occasional leg pain, mostly right down to the knee and most of my low back pain is on the right as well. I am mostly worried about long-term nerve damage, i.e., bowel incontinence, loss of bladder, etc. as I absolutely do not want that to happen and if I absolutely have to have surgery to prevent it I would consider it then. However, at this point I am in the "wait and see" mode as I understand the surgery is very hard, especially with pins and roRAB, etc. Thanks for writing!
 
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