Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Calcification near L4/5 and right ureter I have been undergoing testing for MS for some time and also have had recurring back pain for a number of years. I did not and do not associate this lower back pain with the MS type symptoms, however, there does seem to be nerve involvement. Pain in on either side of my spine in the hip area, deep in my right buttock (the periformus (?) muscle according to a physical therapist I had seen) and down the back of my right leg and into the outer side of my right calf muscle. The doctors recently discovered a hemangioma in my C5 vertebra, a herniated I am SO CONFUSED! I am still having pain, still having neurological symptoms, Where do I go from here? Should I worry about the calcification or just assume it is,
______ You mention a number of very different problems some unrelated - I think that you should definitely sit down with your neurologist and sort through your issues one by one until you have them clarified First, you mentioned that you are affected by extreme fatigue. Certainly, fatigue is a common and disabling symptome in MS patients. Do you definitely have MS or is it unclear? If you have MS, then a number of medications including Amantadine and Pemoline have been used to limit fatigue. The pain you have radiating to your calf sounds like involvement of the roots in the lower back that originate in the spine then travel down and combine to form the nerves in the leg. This is probably why you are getting tests like a myelogram and MRI's. Often a disc or bony fragment will impinge on a root causing symptoms. The solution - back surgery should not be taken lightly - and so whether surgery is indicated is based on many things but especially the nature of the compression and your neurologic exam. Many times the best managemnt is really pain medication/muscle relaxants and physical therapy. Regarding some of your MRI findings - the disc and the osteophyte may or may not be significant. If you took an MRI of the backs of people with no symptoms whatsoever, you still often find bulging discs and bony protrusions. The findings really depend on how severe they are and whether they are related to anything on exam. Needless to say, they do not seem related to your lower back and sciatica-like symptoms. The calcification may be related to your symptoms or may not - not sure where it is or if it's associated with an underlying mass or disc fragment. Since one really needs to see the pictures and know how they relate to you, you're going to have to ask your doctor to explain. I don't think the spinal tap results are related to the surgeon's decision to not operate - more likely after looking at your films, he did not feel surgery would help. When your neurologist says your spinal tap results seemed like they were from a "bad stick", he probably is referring to some red blood cells and other mild changes that can occur when a traumatic tap occurs, that is the spinal fluid is mixed with a little blood from a surface vein hit during the tap. Hope I was able to answer some of your questions. Good luck.
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