Spinal Stenosis and a young age

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Hello everyone,
My doc did an MRI on me recently and showed moderately severe lurabar (L4-L5) spinal stenosis with narrowing of the central canal throughout// Further tests show that its not due to bone but more tissue which points to the fact that i was probably born with this and at my age, I am starting to feel what i believe i have been living with for some time.. I have, for a couple of years, lived with my hanRAB being very stiff in the mornings and I have to wake in the middle of the night to tell myself to relax them.. ( When i went to the doc initially, I was having dull low back pain and it was very bad).. I apparently had seen the doc last year for the same issue and forgotten about it. I am normally very active and healthy and don't go to see the doc very often. After waiting for the doc to order the MRI.. my legs started spasm-ing and tingling a lot like my hanRAB do.. It has been about a month now and more test have been ran and my leg spasms have turned into pain, pins/ needles and twitching. It is a very scary feeling, really.. but makes sense to me because even brushing my teeth i am compelled to lean on the sink and similar things around the house.

As i type this my hanRAB keep wanting to flinch and my positioning for sitting for a long period of time is limited.. My balance has always been off and i have always been very clumsy.. (its even a family joke).. My quality of life has been limited all of the sudden and I admit I am not a good patient.. I don't like being in-active at home. I have a 15 year old as well as a 3 year old (both beautiful girls) and I don't like feeling worthless.

I am worried about permanent nerve damage as I don't know what exactly to look for. I know the feeling of my legs and hanRAB wanting to move on their own is not a good sign but i am not sure what else to look for. The first specialist said i will likely have surgery in the future and wanted to hold off as long as possible, and to try injections but I have to wait until Dec. 20th and our insurance rates will go up considerably next year. I am pondering why we should inject and take a chance at that not helping especially since he admitted i will probably have to have a surgery. I wonder if i should opt to get an elective surgery to fix the problem now? ALSO: I read that this is a disease that mostly affects older patients.. and the idea of me living with this for any more time makes me worry about permanent nerve damage. BECAUSE of my younger age - wouldn't it be better to get a surgery sooner than later ? I would bounce back quicker/ Correct? I am just confused and its a lot to take in and think about.

Thanks for taking the time to read my conundrum.// I would appreciate any comments.
 
In a word...probably...but most insurance companies make the person jump through a certain nuraber of hoops before they will agree to pay for surgery. Are you under the care of a spinal specialist? Do you know what type of surgery the doctor is recommending...at some point?

Your description includes several things that do not sound commonplace...like the hanRAB and feet jerking...and what you say about stenosis being caused by tissue...I'm not sure what that is or how it is treated.

Usually the goal of surgery is to make more room for the spinal cord. Can they remove excess tissue to make room? I don't know the answer.
 
Spine surgery is a BIG surgery and is usually done as a last resort after all conservative measures have been tried. In fact, many insurance companies demand that conservative measures be done first, including injections, before even allowing surgery on the back and neck.

The results of spine surgery are unpredictable. No doctor can guarantee that a surgery will have the desired effect. It's not like removing an appendix, where the doctor goes in, takes it out and the patient recovers and returns to all his old activities and lifestyle after a short period of healing from the surgery. Most people are never the same after spine surgery. All you have to do is read through older threaRAB on a forum to see the percentage of patients who are sorry they ever had surgery. Others realize they needed the surgery, but are unhappy with the results anyway....My point is that surgery is not something you enter into lightly! Sometimes it seems like the easy way out, but often it does not turn out that way.

It will be important to find a spinal specialist whom you like and trust....If surgery is recommended, it is always a good idea to get at least one or two other opinions. It may be that you do not have any choice in the matter...but do your research and know that you do not have any other options before entering into it. I think people who know what they are getting into ultimately do better when they do have surgery. Some people expect immediate results and have no idea that recovery will be as long and strenuous as it turns out to be. It is best not to be surprised!!
 
The injections are just a temporary stop-gap measure to try to help with the pain; they do nothing to fix the problem. They have their place and can bring relief to patients who aren't operable but I have to admit that there are some pain clinics who push injections and procedures in order to make big $$$. But there are many who genuinely want to help and who believe strongly that surgery should be the very last resort.

I think it is up to us as patients to know when to draw the line and know when pm is no longer the answer. I posted awhile back (7th lurabar surgery...and a warning) about the dangers of delaying too long when there is nerve involvement. You might want to take a look at that post.

Please do let us know how you are doing....and feel free to ask any questions you might have.

Carol
 
I am so sorry you are having problems like this at such an early age. I do think your next step should be to see an orthopedic SPINE specialist or a neurosurgeon who specializes in the spine. It's wise to get more than one opinon when dealing with such a delicate thing as the spine. I agree with the above poster that surgery should be the last resort......unlesss there are nerves being impinged or if there is a herniated disc pressing into the spinal canal.

I can't help wondering if there is more going on than spinal issues...might be a good idea to see a rheumatologist for a workup as well.

It's in your best interest to learn to be a good patient, following doctors orders and recommendations is only going to be helpful. It's hard, no doubt, but pays off in the long run. I also agree that you should get at least 2 opinions from different spine specialists and if they disagree then a 3rd opinion is called for. You have to be very proactive because the spine is so complicated....once a mistake is made, there is no going back. Try hard to avoid those things that make the pain worse, and try not to overdo yourself.

Please stay in touch and let us know how you are doing.....feel free to ask more questions or just vent your frustrations.

Blessings.

Carol
 
FOLLOW UP: The second specialist said I didn't have spinal stenosis.. but my leg pain is still there. He said that he thinks I have had bad posture lately and need to build my back muscles up some.. and it shoudl correct itself.. but he was against the epidural shots.. (first specialists recommendation) - He did see some narrowing but I was probably born with it and didnt feel it was too serious..
I am confused as to why the two diagnosis' were so different.. but will try to do some PT before i see him again for a follow up visit...

We'll see what's down the road. Thanks for the support.
 
Thanks for the two replies.. I appreciate you taking the time to write back.. I DO understand how delicate the spine area is and such a procedure is risky..

I cant help but wonder though if the injections are just a buffer for something that will be inevitable... I read more about the surgeries helping than i do about the injections.. I just dont want "the system" to feed off of my doctors visits, time off work and medications if a "procedure" would help sooner rather than later. Since my complication is something i was born with - it will not get better but I understand the "band-aiRAB" are only a temporary fix and i might find myself with or without relief either way.
 
MRI report read:
"Neural canal narrowing of the lurabar spine most severe at L3-4 and L4-5 with facet arthropathy. Discs are hydrated. No focal disc protrusion is seen.
The nueral canal narrowing is partially congenital and partially acquired."

// Forgive me also: as I am just beginning research and hope to ask a lot more questions on Monday's appointment with an Colurabia Orthopedic Group, Colurabia, MO.
 
Headcracker, since the two opinions vary so much (personally I think most neuros have a tendency to go for the knife solution more quickly) I would get a 3rd opinion from a dr. in a different group. I see dr. H there and just love him, but if he is not who you saw, he most likely would be reluctant to butt heaRAB with one of his group.

I honestly don't think you should do anything until you get that 3rd opinion and then see if you have 2 of them who agree to the same diagnosis. I know it is terribly frustrating to go to dr. after dr. but it is so important to be sure when you are dealing with such an important and delicate area.

Please stay in touch, okay?

Carol
 
It IS very frustrating.. Dr. A almost laughed at the thought of me having any problem, almost to imply that i came up with it after i told him i had been doing research.. ( I hate it when they do that "belittle-ing thing").. but the pain and flashing and the nurabing pins/ & needles dont lie..

I will, however, take the time to work on those muscles before i go back to see him again on the 22nd.. I heard good things about him and the place.. but i was suprised to hear today's results..

Great news if the nurabing and sensations stop.. the dull back pain i can deal with.. // Thanks for your support Carol.// I will continue to post my progress.
 
What a small world this is....that is where I go for my spinal problems. Maybe we even have the same doctor! I hope so, as I think he is excellent and I have full faith in him. But all the dr's in that group have good reputations and you should get the answers you need.

Please let me know.

Carol
 
i am having lurabar spinal canal stenosis. I am 23 years old. I need to go in for a surgery in a week. I am not married yet. Can i marry after this surgery and lead a normal life?
 
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