Need Help Please reply - Osteophyte formation causing stenosis

Since about 5-6 week I had pain in the left leg and little tingling in the left feet while walking. I went to my doctor and he ordered MRI. These were the results:

L4/5 diffuse disc bulge, end plate osteophyte seen causing moderate left greater than rignt Nueral foraminal stenosis and moderate central stenosis.

At all other levels everything is normal.

The MRI said the osteophyte are impressing upon the thecal sac but did not clearly comment on any nerve getting pinched.

The MRI was done on october 7th and I have an appointment with my Primary care on October 25th. I have been taking IboPrufen(2 tablets) and the pain seems to be reduced  with the tingling also going down, I just get some pain in the left leg while I walk.

Please guide as to what should I do. I am just 33 years. One of my doctors said I might need to go for surgery.

1. Do I really have to go for surgery (I am diabetic). If YES normally how long should I wait and watch the symptoms. I have read that if the surgery is done within couple of years of the symptoms then the success rate is good.

2. Is my spinal cord getting impressed, should I be too worried about the thecal sac and the ostepohyte causing Neural foraminal and central stenosis OR do they heal with time.

3. Is there any harm is delaying the surgery and how fast does the ostephyte grow causing more stenosis. Is these stenosis in any way LIFE THREATNING

Your advice will be highly appreciated

Thanks

[CCF-Neuro-M.D.-JT]

Sorry to hear about your symptoms. Whenever someone asks me to give advice based on MRI reports, I first have to give my usual disclaimer which is: Because I have not personally reviewed your films nor have I examined you, I cannot give an accurate opinion. What I can do is give my best medical guess.

Ok, having said that:
1. No, especially if you're getting better with conservative therapy. Keep in mind you are at higher risk for complications post-op due to diabetes.

2.No, your spinal cord ends at L1,L2. What's left in the thecal sac are the little nerve roots that extend from the end of the spinal cord. However, it sounds like you have a radiculopathy with the pain and tinlging which means compression of the nerve root.

3.This is NOT life-threatening.

It sounds like you have some degenerative bone disease that is normal with age, though you are relatively on the young side. Before jumping the surgical gun, get a neurological or neurosurgical consult and have them review the films with you. An EMG may also be helpful to see what kind of shape your nerves are in in the lumbar region. At any rate, you have time to think about your options. Physical therapy may also be helpful. Osteophytes don't go away. But unless you develop progressive weakness and sensory loss with intractable pain despite conservative measures, there is no urgency to undergo an operation. Hope this helps. Good luck.

[Adele]

Glad you got through!  I also have spinal stenosis!

[pakoo]

Thanks a lot for all your answer.

Is there a cetrain guideline as to the wait time for the surgery OR it all depends on the symptoms. Right now I do not have any weakness or Numbeness in the left leg.

Also generally how fast do the ostephytes grow

[Adele]

If you want the doctor to see your last comment, You need to make another post to the Doctor, not here in "post a comment", because "Post a Comment" is for patient-to-patient comments only.

[Avenution]

I'm curious if anybody can shed some light on something I recently found out. Two years ago I went to the Doctor (Internal Medicine) due to severe fatigue, joint and muscle pain and and generally feeling bad. I was diagnosed with Graves disease in 93 and treated with Radioactive Iodine. I've been on Synthroid since that time. After my visit with my Doctor 2 years ago he sent me to a spine specialist who ordered a MRI and a Bone Scan and a Bone Density test as well. It turned out I have Osteopenia (thinning of bones). That is all that they told me they found which was significant to me as I am a 46 year postmenopausal female. I know I will experience more bone loss during menopause.

I also have very bad neck pain. After I get a massage it triggers something in my neck so painful I lose sleep and can barely move my neck for about a week.

Last night I was going through my medical records and came across the report done after my MRI or my Bone Scan. It said that I have Osteoporosis with marginal osteophyte formation scattered throughout the thoracic spine. On another report it said they found an "abnormality in the posterior left temporal lobe. That finding is most consistent with bone island or small cyst". I was never told any of this, I was only told that I had Osteopenia and that everything else was normal. Why would a doctor ignore those findings when the whole reason I went to him was due to pain in my neck, lower back, left arm etc. So my question is what is Osteophyte? Also what is a bone Island and what would cause a cyst to be in my neck? could this be the cause of my severe pain. And lastly can anything be done about any of these?  Thank you, I look forward to a response.