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Further To Back-Pain Investigations - I Need A Bit Of Knowlege Here - Help!

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jourdain2 | 23:13 Thu 01st Jun 2017 | Body & Soul
6 Answers
Chronic low back pain history L. sciatica. Had MRI scan recently. This says "Sagittal and axial T1-weighted images demonstrate lobulated increased signal intensity in the posterior epidural space throughout the lumbar spine most prominent at L3-L4 and L4-L5 disc levels, causing vertical displacement and narrowing of the thecal sac, comparable with epidural lipomatosis causing acquired canal stenosis. ................At L4-L5 a prominent central left paracentral annular protrusion causes severe compromise of the lateral recess with compression of the L5. At L5-S1, bilateral intraforaminal L5 nerve roots are compressed from encroaching disc and proliferative facetal hypertrophy. In addition there are minor impingements of the inferiorly traversing S1 nerve roots.
Normal marrow and cord signal however,( phew! ) Normal pre and paravertebral soft tissues."

I know it is not particularly good news - I've got a bad back! I can make sense of a lot of it, after all this time. But my GP is baffled by epidural lipomatosis (never heard of it) and is referring me to a neuro-surgeon. I've looked it up and I do not fit the major causes (obesity is one) of which one is long-term steroid use for asthma - I've been on asthma treatment less than a year and no steroids before. I seem to fall into the 1% of unknown causes. I'm a bit worried t.b.h.. I can't access a lot of medical sites. Any advice/help out there? Sqad?
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I will try and sum this up as simply as possible. You have typical changes on your MRI scan which indicate degeneration, collapse and compression of the nerve roots coming out of the lower spine, causing you lower chronic backache which in essence is ...sciatica. The bony collapse of the lumbar and sacral vertebra, may cause other problems with your bowels...
02:22 Fri 02nd Jun 2017
I will try and sum this up as simply as possible.
You have typical changes on your MRI scan which indicate degeneration, collapse and compression of the nerve roots coming out of the lower spine, causing you lower chronic backache which in essence is ...sciatica. The bony collapse of the lumbar and sacral vertebra, may cause other problems with your bowels and bladder...may....not necessarily. Now this epidural lipomatosis is not a really big deal and it is the growth of fatty tissue which adds to the compression of the nerves, already annoyingly undergoing compression...a sort of "double whammy".
Be reassured, there is no suggestion of any malignant process going on and your problems are purely degenerative...wear and tear.
Now the problem with you will be how to treat your back....long term medication OR spinal surgery to relieve the compression (laminectomy).
The cause of Epidural Lipomatosis is unknown.
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Thank you so very much, as usual, Sqad. I am much relieved. :) x
"longterm medication OR spinal surgery"....
Or, in my case longterm medication, AND THEN spinal surgery.
TWICE!
Question Author
OUCH! gingejbee. Poor, poor you. I've had this a long time(over 10yrs)& got desperate at Easter. GP now trying acupuncture which seems to be helping a little. Did your ops work in the end?
Hi jourdain....well, yes and no. The first op did the trick and the results lasted donkeys' years...but then it all started again and I saw a specialist privately, who put me on his NHS list. Second op also improved things dramatically....but, as you realise I'm sure, once you've had surgery on your back, things are never going to be "as new"- you'll always have to be aware of your limitations. It plays up even now sometimes...but it improves with careful exercises and I bought a Bac-Rac and use it several times a week....highly recommended by me (although not for everyone). Good luck with your treatment.

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Thank you for that recommendation. It sounds better than the wooden-bead thing from Argos. I'll give it a go. Best wishes. :)

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