Herniated Disc is the issue

[John K]

I had an MRI done and the findings were not good. The doctor referred me to a nerualsurgeon and told me that surgery is a possibilty given the disc in the thoratic.  He also said that there is a lot of damage to my spine for someone who is only 29 years old.  He told me the the damage to the lumbar is not at this time significant but the damage in the thoracic is.

(These are the conclusions from the MRI)
Conclusions:
LUMBAR:
Central left small herniation or protrusion at T12-L1 with possible left L1 nerve root impingement. Disc bulging with ligamentum flavum hypertrophy at L2-3 with mild canal stenosis.

Central disc bulging L4-5 with flattening of the ventral thecalsac without significant neural impingment.

Small central protrusion L5-S1 impinging on the ventral thecal sac but again without significant neural impingement

Old compression deformity anteriorly of L1.

THORATIC:
T12-L1 mild to moderate canal narrowing due to either disc or osteophyte compression on the ventral thecal sac. There is mild crowding of the roots of the cauda equina within the thecal sac at this level.

Mild compression deformity L1.
Remainder of the thoracic spine and spinal cord are entirely normal.

MY SYMPTOMS:

At this point, the pain only occurs after laying down for a significant amount of time.  I can go to bed at say 10:00 pm and wake up at about 4:30 - 5:30 with alot of pain in my midsection. If i get up and walk around the pain wears off after about 1 hour.  
I have neuralogical signs of weakness and a strange sensation in my left leg, particullary in the calf and lower portion of the thigh. I also get muscle spasms that are small and not painful. The symptoms can vary some days they can be minor and other days that can be worse.  There also occur in the right leg but to a much less extent. I also get some weird sensation in the left arm as well but this is also minor and occurs much less frequently.

My Questions

Are my neural symptoms reversable if appropriate action is taken?
If surgery is required, What are the risks?
Do you think it is odd for someone my age (29 yrs) to be having this kind of damage?
If so can weight lifting and bad posture cause this level of damage? I have never been in an accident but injured my back shoveling snow about 2 years ago. It took 4-6 months just to get over it.

[lstmymind]

A related discussion, spine was started.

[John K]

I went to the Neurosurgeon the other day and told me that the spinal cord is not being pinched and therefore he does not think my leg symptoms are related.  I would still like to know why my back kills me in the morning when i wake up and disappears after being up for an hour.

My leg has a funny sesation from the knee down to the heal that makes it appear as if i am weak.  I also get muscle spasms and twiching in both legs.

He did an exam where he had me walk on my heals and then on the ball of my foot and then jump up and down on one leg on the ball of my foot. He said that was good. He also used the rubber hammer on my knee to test reflexes and said they were symetric.  He believes that my leg symptoms are due to Restless Leg Syndrome and gave me some valume for it.

I am now wondering. If I have RLS then should i have blood test done to check for any vitamin deficienties?

[CCF Neuro[P] MD, RPS]

Dear John:

Sorry to hear about your back problem.  Without doing the exam, the sounds of the MRI, it does not seem as if surgery should be jumped into as the first thing to try.  The only real concerning finding is the "possible" nerve root compromise at L1.  Otherwise, although there is some herniation, there is no really bad cord compression.  I think the initial route of action would be to find a good rehab specialist and PT and begin that type of rehab.  If this fails, then maybe surgery might be warranted.

Yes, incorrect form with heavy squating can do alot of back damage. In addition, bad habits of lifting heavy objects can also play a role in degenerative process.  There is the added dietary component and bad genetics or systemic diseases.  Unfortunately, having a bad back is not as age related as one might think.  However, it does not seem like things are irreversibly worrisome.

CCF Neuro MD