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Avatar universal

intrpret this mri please

Here goes been in chronic pain for a couple of years now. Norco tens work fine for it. I am 31 they are trying to get me into surgery asap. Can anyone read this mri or at least interpret it my pain is bad.
Would also appreciate it if anyone has insight as to what kind of medical trouble I am facing.
Here goes:

Findings:there is central canal narrowing secondary to epidural lipomatosis most prominent at the level of L4 but also present to some degree at the level of S1.Disc bulging at L4-5 is also noted. (His finding combined with moderate bilateral facet hypertrophy and the epidural lipomatosis,results in moderate to severe central canal stenosis.
Disc bulging at L4-5 results in moderate to severe left greater than right foraminal narrowing


Impression
I epidural lipomatosis results in narrowing of thecal sac particularly at L4 This combined with disc bulging and facet hypertrophy at L4-5 results in moderate to severe central canal stenosis

II. Moderate to severe left greater than right neural foraminal narrowing at L4-5

So it appears I have epidural lipomatosis google this one and see what can happen to you, bulging disc and a hefty case of spinal stenosis. What will happen to me if I don't get surgery. Help me please.
12 Responses
Avatar universal
First off, Welcome to the Pain Forum. I'm so glad that you have found us!! I'm so very sorry that you are having so many problems and so much pain. I'm glad that you have a diagnosis so that you can get this taken care of!!!

I googled Epidural Lipomatosis but, my question to you is what did YOUR Dr. say would happen to you if you don't get the surgery?

What caused this and have you done any of the things that were suggested trying before the surgery to see if it remedied the problem?

Looking forward to hearing from you. Hang in there as we are here for you!!...Sherry
Avatar universal
I'm sorry, I meant to ask exactly what type of surgery are they talking about. Is it for the Epidural Lipomatosis or for the Bulging Disk or is it a treatment for Facet Arthritis?

Thanks....Sherry
Avatar universal
Okay doc said I had to have surgery but my insurance ran out. All I was told was I have spinal stenosis finally got a answer out of a doc he told me that I
My spinal canal is just going to shrink till I am paralyzed one day. Spinal stenosis is major surgery. I am about to drop 250 bucks to pain management they better give me some pain meds seriously. As far as any doctor helping me none really will tell me. They r saying my weight is aggravating this and if ihave surgery I will not recover at my current size. I am so scared.what is facet arthritis. Also ihave a pars defect very prominent at L4 I have found online that is a fracture basically. I am also told spinal stenosis is a birth defect. Stenosis was first discovered in 1975.occurs mostly inobese white males. It is a fatty tumor wrapped around the spine.
Avatar universal
Also they the neuro doc I was seeing was very vague not helpful at all. I can't take mobic lyrica elavil nor can I tolerate gabapentin theyhad me on 1800 mgs a day of that and it made me feel funny and I was losing my vision on that. I am allergic to darvocet and elavil.the only thing that has helped so far for pain was norco. I live n texas and when I was n missouri the er gave me percocet 10 650 which I am told isn't available n texas. Perc helped but not much.what do I do with no insurance I cannot keep running to er for pain meds. I will get in trouble it is bad all I can say is screw those celebrities that ruined it for people like us who actually need help. Preciate yah. And thank u for weLcoming me to your board.
Avatar universal
We're glad that you found us!! Please understand that we are ONLY CP (Chronic Pain)
patients and NOT DR'S. Just want to be sure that you know that.  :)

One of the things on there that I read was that if it was caused from being overweight that a lot of times losing weight would correct it. PLEASE check with your Dr. and see if that is a possibility for you. It would sure beat surgery!! The other thing that they said caused it was the use of steroids for a long period of time. Such as for medical issues etc. That was the other thing that they said could help it go away was to give up the steroids (get off of them). Since yours sounds like it might be caused from weight I would sure check with your Dr.and see. I would also, get a 2nd opinion and fast. I wouldn't go into this with only one opinion. You need to find a Dr. that can give you ALL the options!!!

Please let us know how it goes. We are here to help you any way that you can!!!
Avatar universal
Hello,

I know a lot about back and neck issues, a buldging disk is completelly normal (so the neurosurgeon) stated.  Most americans have them and many people don't even realize that they have them until they get a mri and that's when it does show up.  I've had one surgery for a fractured disk, I have 1 herniated disk still in my back but have never had the stenosis, so I'm not sure what it is. Also, if you have any type of weight issue, it can increase the chance of that to, so I've been told by the neurosurgeon that worked on my neck.

Regarding medications, have you ever taken Tramadol, or toradol?  I noticed that you are allergic to a lot of non narcotic medications, but seem to be able to stomach the strong stuff that normally causes constipation, or feeling funny, except for the darvacet which is a very mild pain medication.  I did take neurontin, and it also made me feel funny so the doctor lowered the medication and I took it at night, and I never took that high of a dose.  You don't mention being concerned at taking the high dose of norco.  One question I have for you?  How are you affording the norco?  If you have no insurance, then you are paying out of pocket for the medication and I know that it can be very expensive.  If you have no insurance you could get on a state insurance and find a neurosurgeon that works with the state?

Toradol is a non narcotic medication that they have given to me many times for pain for kidney stones, which if anyone knows, is one of the most, incredible pain that anyone can experience, along with childbirth.  Toradol is very strong and works instantly, and considering it is a type of ibuprofen, I've not heard of anyone not being able to tolerate it. It definitely doesn't give you a "high" feeling, but it works terrific.  You should try that.  Tramadol is also very good, I take that at home.  I was on norco and requested to be taken off of it, and I switched to tramadol and it works great.  I also get epiderals in my back for the buldging disk that I have.  You didn't mention that you have done anything, beside medication?  My pain managment doctor has me see a physical therapist, have the epideral injections, and also medications to help.  I'm sure you would be an excellent candidate for additional therapy besides narcotics, but I find it sad for you to write" they better give me pain meds, seriously."  Are you really interested in finding out the source.  I also want to tell you something that I'm not sure that you have heard of.  My best friend works in the ER department (here in KS) as a CT technician.  He told me that the hospitals keep a list of individuals around the state that continually come in for pain medication. I just wanted you to be aware that running to the ER continuously may not be the best thing, as they keep track and share the information with each ER in your area.  I'd hate for you to go in there when you really need assistance and them to turn you down.  Please be careful, and see the neurosurgeon and get the proper treatment that is needed.

I definitely believe in pain medications, as I have been on many over the last ten years for my hysterectomy, disk fracture, ACL tear, gallbladder removal, etc... it just concerns me when an individual types up that they just want pain meds instead of trying to get physical therapy, epideral injections (which take away an enormous amount of the pain that your experiencing and then wouldn't need as strong of narcotics) if you are interested in really taking away the pain of the disk.

I hope I've mentioned a few medications that are alternatives to narcotics and have given you a few options about treatment.  I hope the pain management doctor is able to help you and provide you the medication that you want.  Good luck!

Avatar universal
The norco works but I don't have to take it all the time. I am agitated at being n pain. I have had toradol and took ultram tramadol didn't work. I use a discount pharmacy card called familywize that is how I can afford some meds. Yeah texas hasn't implemented there database yet but it is coming. I have nothing tofear as I don't have insurance or the money to doctor shop. It is scary though you mentioned that I take high doses of norco lol 2 a day isn't nothing.but I thank you for helping me with your insight. If anyone can help me with more input I would appreciate it. Elavil makes my heart palpitate and makes me feel like I am leaving my body. Darvocet makes me throw up.
1301089 tn?1290670171
Definition of spinal stenosis

http://www.medterms.com/script/main/art.asp?articlekey=11575

Good article
Avatar universal
I have heard lots of bad things about steroid injections cortizone shots they take years from your life. Yes I am interested n finding various therapies
So please fire away it is interesting though that a lot of insurances and medicaid won't pay for a glorified anesthesiologist LoL to put a needle in ure back and say this will help. I had a spinal tap a myelogram and they will never ever ever stick a 22 gauge needle in me like that again. No thanks.interventional pain management isn't a recognized specialty which is interesting.
Avatar universal
As for my weight neither it nor steroid use caused this.I am the third of 4 children my older sib has avascular necrosis and had boTh hips replaced at 33. His was caused most likely from drinking I neither drink nor do drugs. The only thing I can think of is bad genes.
Avatar universal
Wow, I'm sorry to hear that nothing seems to help.  I apologize, but you never mentioned that you only took 2 norco a day but what you did mention was that you took the 10's which is the highest form that they come in.  They come in various forms from 3.5 to 5, 7.5 and 10.  That was why I mentioned the high dose; since darvacet makes you vomit, have you tried taking zofran (nausea drug they give for chemo patients) that medication works wonders, and I'm wondering if some nausea medication with some of the alternate meds would work for you.  What I gathered from your message was that no medication helps you, except norco and now after reading the other messages, it seems that you won't (or can't) have any epidural injections to ease your pain.  It is scary that hospitals keep track like that, on one hand I understand why they do it, but on the other hand, it's because they feel everyone is drug seeking.  I was just in the hospital last week for a hernia, and the nurse that was taking care of me kept complaining that everyone she see's anymore are patients that are allergic to all types of medications, that basically beg for pain medications and get mad when they can't get what they feel they need.  It totally made me feel like I couldn't ask for any type of medication and ended up just taking toradol because she had me so freaked out about asking for anything narcotic.  It's a sad environment.

I hope they can help you, and that they figure out exactly what is happening to you.  How are you supposed to have surgery if they won't approve an anesthesiologist?  That doesn't make too much sense, if your insurance that you have won't approve that then you won't be able to do anything.  So, sorry if I insulted you, it by no means was to do that.  I was honestly trying to give you a different approach and wanted to let you know some of what you wrote made it sound like you were wanting to just stay on the norco and do nothing else to help your pain.

Let us know what you find out!  You are way to young to suffer through this all by yourself.  Keep posting, and if I hear anything new from my neurosurgeon I'll be sure to send you a note!!
Avatar universal
Thank you. You didn't offend me. I just watched my mother go straight from norco to er morphine to fentanyl patches then to liquid morphine then she died. She had cancer. But the deal with me is I am nOt looking for high powered narcs just norco seems to help. I can't take darvocet cause it causes the blood vessels in my eyes to rupture.as for my weight like I said it didn't cause all of this and I need to lose weight. But I am miserable eating loads of tylenol and ibuprofen nothing helped.
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