Help Requested Regarding Test Results

[ezmirellda]

I have Osteo Arthritis, Fibromyalgia, severe RLS and several other maladies. I am in pain all the time and find I cannot walk or stand (even with my cane) or even sleep for any significant length of time . I recently had x rays taken and have included the results below. I was recently measured and find I have lost 4 inches in height. I know in general I am losing bone and have a Pre-Osteoporosis condition. I wonder just how serious is my back condition? Am I a candidate to consider having surgery? I feel my pain is severe and my inability to perform general duties and tasks has tremendously impacted my quality of life. I am not a medical person and cannot quite interpret these results. Can anyone illuminate me here please. The more I read about spinal surgery the more unsure I am about any procedure including the back.

STUDY: SPINE LUMBOSACRAL 3 VIEWS
The bones are diffusely osteopenic. There is compression with
anterior wedging of the body of L1. There is loss of approximately
30% of vertebral body height anteriorly with associated increase in
thoracic kyphosis. Mild chronic anterior wedging is also seen at the
T11 and T12 vertebra. Anterior spurring is present throughout the
lumbar spine. Facet narrowing, sclerosis and spurring are present
from L3 through S1. This is most severe at L4-5 and L5-S1. There is
slight retrolisthesis of L1 in relation to L2, of L2 in relation to
L3 and of L3 in relation to L4. The pedicles and neural arches are
intact. Mild spurring is present along the anterior-inferior SI
joints. There has been prosthetic replacement of the right hip.

IMPRESSION:

Diffuse osteopenia.

Compression with anterior wedging of the bodies of T11, T12 and L1.
These changes are probably chronic and are associated with increased
thoracolumbar kyphosis..

Slight retrolisthesis of L1 in relation to L2, oh L2 in relation to
L3, and of L3 in relation to L4.

Severe facet degeneration from L3 through S1.

Prosthetic replacement of the right hip.

[ezmirellda]

Dear Nightmare Rick,
                               I appreciate your response. Here I was thinking I was being a wimp. Or that the Doctors thought I was exaggerating and could do more. I have been doing extra walking for them. But if I dare asked for Percocet or Fentanyl fairly certain the next stop for me would be having the doctors placing me in rehab, or my pain meds would be cut off entirely. Most Doctors I find are extremely hesitant to prescribe any pain medication. But I then think who were these pain meds designed for but us? They already have lowered my Soma. Which is the one drug that really helps my RLS and helps when taken with Vicodin for extra pain. I am only allowed 16 pills a month. It is not like I do not have a medical condition, or are taking my meds for recreational purposes.  With the Arthritis, Fibro, RLS and now Shingles I have had a hard time getting my 3 a day Vicodin prescribed and filled. Even though though the bottle says may take two a time, if I do I run out of my monthly allotment. I am tied to my hospital for financial reasons. And for the most part I think my Doctors have been attentive. How do I get them to understand just how hard my daily life is to function, and how severe my pain is with these conditions? And how do I get them to entertain other medications and procedures without them thinking I am addicted or micro managing them? I am thinking maybe I should copy these posts and send them to my doctor. It may be allot of reading but if you are up against surgery and pain I feel it is worth the effort. I don't smoke by the way. Your idea of two canes is a good one. I have the crutch that wraps around you arms that I think may provide more balance for me. I have not been told about most of the procedures you mention so your comments are invaluable. Thank you for illuminating me. You all have been unbelievably kind and helpful. I would not known of any of this without you. The best of luck with all of your conditions. My thoughts are with you as well.

[Nitemare1]

When you wrote weight bearing I almost went into shock, are they crazy? The previous reply is correct about a brace for sure to bear the weight of your upper body on your hips rather than your obviously destroyed Lumbar joints. 30% bone loss is extravagant. The only surgery I can see them doing is a fusion with instrumentation which is steel bars fastened to your lumbar spine from S1 and up to L5 or 6 to stabilize your spine permanently but I'm unsure with all the bone loss if it's possible. This is a major surgery but honestly if you have a really good Dr. I would do it and already have but only up to L4. You will need a special brace after as the fusion takes months to finish and a walker for some time but being able to walk without a cane even is worth it. Again as above I'm not sure why the Dr.'s didn't discuss this with you. I have gone through this myself and it makes a giant difference. Once again the previous reply is correct in the pain meds. You should be on some kind of long term patch such as Fentanyl which continues to give good pain relief for three days then change to new one as well as short term such as Percocet for break through pain for when you have done things that cause more pain than the patch will not help totally. There is also Facet joint denervation that can be done to control pain. This is burning of the nerve tips in your Facet joints, it will be a bit more painful to begin with but the effect can last up to two years if you're lucky then redo it. Now if you are a smoker quit as you read, smokers have a large chance that a fusion won't take but it will take some time to get things set up. I'm sorry I didn't see your age but once again the older you are the harder the recovery and the odds that an Orthopedic Surgeon will do it. Unfortunately for me I've gone through 4 surgeries but the Surgeon was trying to get away with doing as little as possible but I would have been better off if he did it all at once. You will definitely need help at home for some time after but if it goes right you will be much happier after. I feel for you for what you're going through and what you will and wish I could be of more help. Oh and don't use just one cane, use two to keep your weight centered, it will help you more and make it better for your new hip, you don't want it wearing out prematurely because of poor weight distribution and try doing as much lumbar strengthening exercises as you can to help support your back, crunches etc.Good Luck, my thoughts will be with you.
Rick

[ezmirellda]

Thank you for commenting. I appreciate it. There has been no talk of any brace. The docs want me to do some weight bearing exercise. Right now just doing household chores and my art are as much as I can handle. I suggested swimming but that was not enough for them. The docs did not go into details other than there were compression fractures. I cannot interpret the rest. As I am currently battling Shingles in addition to the other problems I am just trying to do daily tasks and self care. I sure would be interested in what kind of spinal surgery may benefit me. Have you had surgery? Do you suffer from any of this?I do not want to end up a hunchback. Being able to walk again for any prolonged distance would sure be nice. Maybe I need another Dr. Thank you again for responding.

[ggreg]

The physician who ordered the scan is supposed to tell you what treatment plan he recommends based on the radiology report.  At the very least, he should have immediately prescribed a good back brace to stabilize your spine, and he should have also prescribed opiate pain killers and the medicine Lyrica for nerve pain.  The opiates would also help your RLS and the Lyrica would help your fibromyalgia.  I am unsure about the benefit of physical therapy for you, mainly because your spine is so wrecked up.  And while I am only a layperson, this is a patient-to-patient forum, and while I am opposed to spinal surgery unless there is some risk of paralysis, I DO think you could benefit from some surgical repairs to your spine.  But you must speak to the doc who ordered the scan, AND someone must take over your care and DO something for you, be it moderate treatment or on up to surgery.