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Sensory abnormalities in the saddle area
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Sensory abnormalities in the saddle area

Hello. I am 19 years old, very tall and thin. My back is not very strong and i have decreased lumbar lordosis, which is starting to cause me some problems.
About two months ago, i bent down to pick something up and felt sharp pain in my lower back, which went away in about a day or two, leaving no other symptoms. Occasionally, when i moved a lot (dancing for example) my back would start to ache, but it would go away in a day or so.
Last month, after playing basketball vigorously, i woke up the next day with a sort of numbness in the sacral area of my back and the inside of my buttocks, right through the anus. I don't know how to define it, it wasn't anaesthesia, because i could still feel pinprick pain and light touch, but it felt weird.
Over the next two weeks, this symptom slowly took over the whole saddle area, starting with my anus, then the perineal area, the scrotum and finally my penis. This got me worried and i went to see a doctor, i got an MRI and it showed a small disc protusion in the L5-S1 and other several minuscule protusions of the other lumbar discs.
Pain is not the biggest issue in my case, as it is often quite manageable. What scares me is this sensory abnormality, the escalating hypoesthesia in my genitals and weird feelings in my bowel (the internal anal sphincter seems to be hypertonic, while the external harder to control than usual). I've also been constipated since the whole thing, being able to go to the toilet only once a week and left with a feeling of not emptying my bowel.
Feeling in my penis has evolved from mild hypoesthesia to near anaesthesia (parts of the skin barely respond to pinprick). My erections are weaker but they're there.

Can this slight disc protusion be causing all these symptoms? My neurologist doesn't quite know what to make of this. Could the disk have moved in the weeks following my MRI? I remember it's only these few weeks that I've started experiencing tingling/pins and needles in the sole of my feet. I had to lift some heavy woodblocks, but, while it hurt my back a bit, it went right away.

I'm very confused. I do not have diabetes, my blood tests are normal.

Here are some images from my MRI:
http://img99.imageshack.us/img99/3666/mri1uu5.jpg
http://img519.imageshack.us/img519/764/mri2ko6.jpg
http://img134.imageshack.us/img134/5931/mri3ux0.jpg
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4 Comments Post a Comment
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Avatar_n_tn
You need to get back into see the surgeon immediately. What you are describing sounds eerily like Cauda Equina Syndrome, which is a compression of the lumbar/sacral nerves. There is a very , very short window of opportunity to minimize the damage caused by this compression.
Call your doctor today, and tell them all of symptoms you are  having.
You do not want to have to live with the aftereffects of Cauda Equina Syndrome if you don't have to. Take my word for it.
Your neurosurgeon? Is he board certified in Spinal Surgery? If not, you need to find one who is, TODAY!
Tell them that you believe you have symptoms of Cauda Equina.
Sandi M
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Avatar_n_tn
Yes, this was their first diagnosis. But if you looked at the image links i've posted, on my MRI there is no evidence of nerve compression to the cauda equina. Also, my symptoms haven't got any worse in a couple of days, and with CES everything happens very fast. Still have no problem urinating.
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Avatar_n_tn
DB,
I was diagnosed with a post op case of CES, which also by the way did not show on the MRI's/CT scans but was certainly there when I had the second surgery. I had difficulty with retention and then a final loss of bladder control, which has resulted in permanent damage.
I would not be quite so quick to rule out CES, and would suggest that you watch symptoms and not so much on the films. MRI's and CT scans are not the end all , be all in diagnostic medicine these days. I am aware of many people in the same boat as I am who were also told there were no signs of CES, yet everyone of them was also diagnosed with it.
I still think that what you are experiencing is eerily resonant of CE compression, and your symptoms are escalating, as you said yourself.
One of the biggest mistakes that I have heard about surgeons making is not understanding that all of the symptoms of CES do NOT have to be present for it to be CES. It depends entirely on what nerves are being compressed at what levels that determines what parts of your body will be effected.
And recumbent MRI's are also notorious for missing CES, unless it is accompanied by a large herniation. They take the pressure off the nerves, because of the wedge placed under your legs, which reclines you in a quasi- sitting postion.
Anyway, good luck, and I hope that I am wrong.
Sandi M
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Avatar_f_tn
hi im jude i av had ces for 5 yrs now and find it very hard to cope with is there anybody else that feels the same
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