Lumbar spine CT scan

[agate]

By popular demand (well, sorta) I'm posting some of my CT scan report (lumbar spine):

There is a chronic appearing superior endplate depression fracture deformity of the L2 vertebral body. No other lumbar compression fracture deformity identified.

Levoconvex scoliotic curvature of the upper lumbar spine present. Additionally, there is grade I anterolisthesis L4 on L5. There is trace retrolisthesis of L2 on L3.

Advanced degenerative disc disease involves L4-L5, left side predominant. Moderate and advanced degenerative disc disease involves L5-S1 as well as L2-L3. More mild to moderate degenerative disc disease involves L3-L4.

There is hypertrophic facet arthrosis present at the L2-L3 through L5-S1 levels.

There is moderate appearing bony spinal canal stenosis involving L3-L4 and L4-L5. This would be better detailed with MRI. Left side predominant moderate bony neuroforaminal stenosis noted at L3-L4 through L5-S1.

IMPRESSION: No acute lumbar spine fracture detected. Chronic/healed appearing superior endplate depression fracture deformity L2 vertebral body. Superior portion of the L1 vertebra is not included on this exam. Scoliosis, degenerative disc disease, and hypertrophic facet arthrosis, with bony canal stenosis involving L3-L4 and L4-L5.

I'm pretty sure all of these findings are probably typical of people who've lived long enough to have put strain on their backs. What I really love about this report is the word "healed" in connection with the fracture. .Since the grim pain I'd been having has pretty much subsided now, it was my impression that it had healed, and it's nice to have that confirmed.

[Virginia]

I noticed it said that when I was reading it. Are you going to the Doctor so that you will get a final breakdown if one is needed, or do you think your Doctor will notify you by e-mail of his findings.?

[agate]

She sent me a message suggesting possible referral to a spinal surgeon. But if that pain isn't a recurring and unbearable thing, I'm not keen on that idea. I have an appointment with her in early August, and I'm going to ask about possible (nonsurgical) ways of fixing my hunched-over back and the loss of height. Maybe more PT, maybe a back brace--? I'm just guessing here.

[Virginia]

Agate, I think we have all been told walking and more exercise, but you are doing those things so I don't know what else to suggest. I know you follow a very strict diet that on the surface sounds very healthy, but maybe you should discuss this with your Doctor to see if you need to incorporate more foods into your diet. I realize you have to take diabetes into consideration, but there still may be other things to consider. Maybe keep a list of the foods, and how much for a week that you eat, take it to the Doctor and see what they think.

My middle brother has also been told to have back surgery, and while I don't want him to suffer, I am not in favor of surgery unless a person is suffering so much that it is just absolutely necessary.

[agate]

Hmm, maybe the doctor would recommend adding more chocolate...

About back surgery, I've known several people who've had spinal surgery, and it seems to have been far more of an ordeal each time than the people expected. Their recovery was long, often involving long stays in a rehab place that didn't seem to be doing much for them, and I'm not sure how much better they were afterwards.

If a person can just wait out the back pain long enough, it does usually get better but it does takes months sometimes. I've often heard that most spinal surgery is unnecessary. I hope your brother can find a better option.

The older I get, the less I like the idea of giving some surgeon a chance to rack up another surgery on his record while I have to go through quite a bit of suffering (and let's not forget the expense) for an outcome that just might be a bunch of complications I wouldn't have had otherwise.

[Earth Mother 2 Angels]

((((((Agate)))))) ~

That is good news that your fracture is healed, and you aren't experiencing unrelenting pain.

My dear friend's elderly dad had two spinal surgeries, and your description of it as an ordeal requiring a tedious recovery and rehabilitation is spot on. It's even more difficult, when you are on your own without help.

While I don't think that I've experienced any spinal fractures, I'm in a similar situation as your are. I have shrunk 4", and I slouch. I would like to correct the scoliosis, but I will not consider spinal surgery. I also won't consider Fosamax, Boniva or Reclast. Several of my friends have had serious side effects from those drugs, with very little improvement in their bone density.

I will be interested in your doctor's opinion about non-surgical options. It seems reasonable that those options should be tried before considering surgery. In our Senior years, any surgery can be risky.

Sending you healing, positive energy ~

Love & Light,

❤️❤️❤️❤️

Rose

[agate]

About bisphosphanates, they're considered risky after about 5 years. If they're so risky that they have to be so carefully monitored, you have to wonder about taking them at all. I've wondered about it for years too, Rose, and haven't ever opted in favor of trying one of them.

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[Virginia]

I tried Fosomax many years ago. I took it exactly as directed and stayed standing for even longer than recommended. Still I had chest pain and my Doctor told me to stop it after a short period of time.

I suggest the chocolate.

[agate]

Suggestion being followed.

There's something unsettling about this part of that article:

long-term use of these drugs has been associated with an increased risk of bone death in the jaw and unusual thighbone fractures

"Bone death in the jaw"? I realize that these complications are rare but I really hesitate to try any medicine that involves such a serious possible "adverse event."

[agate]

I'd appreciate it if someone could tell me what a pain management specialist is. The doctor's note on the CT scan results suggested two options--a spinal surgeon or a pain management specialist. I'm not sure what such a person does. Would that be someone oriented toward physical therapy? Would that person be an M.D.? I've looked it up on the Internet and get quite a few different definitions.

[Earth Mother 2 Angels]

((((((Agate)))))) ~

Here are three examples of my friends' experiences on bone density drugs:

1. She went to ER thinking she was having a heart attack. No. It was Fosamax. She has permanent esophageal damage.

2. She broke her wrist, when her dog pulled on the leash. Her doctor said it wasn't because of Fosamax. But she had never broken a bone previously.

3. She, who just turned 100 years old, had jaw necrosis with Fosamax, Boniva, and Prolia.

Note that all advertising for these drugs is targeted toward menopausal and post-menopausal women. I guess men don't have bone density problems like women, because we have to deal estrogen and progesterone losses?

My theory is that women decided not to take Hormone Replacement Therapy drugs, and Big Pharma brought out the bisphosphanates, to beef up their sales and $$$$.

I have no experience with pain management specialists, but I think an MD supervises all treatments. Treatments may include physical therapy, pain medications, and options like a TENS unit or a baclofen pump, which Sunshine 2 has.

I would pursue non surgical options first before surgery.

Love & Light,

❤️❤️❤️❤️

Rose

[agate]

Thank you for the thoughtful reply, Rose. I understand that men do get osteoporosis too but it's much more common in postmenopausal women.

I'm afraid you may be right. Big Pharma is so very very big that I can well imagine that many of us are just tools of that industry, being exploited rather than cured and sometimes being badly harmed by Big Pharma's bright new ideas. All of the advertised drugs I'm seeing on TV these days make me wonder what has happened generally. We're supposed to view these commercials about these exciting new drugs and discuss them with our doctors. Weren't doctors usually the ones to know about and suggest possible drugs for our conditions? Now the drug companies are bombarding the public with possible wonder drugs for every imaginable problem. This is one very powerful industry. It must have plenty of resources to make all of that advertising possible.

[Virginia]

Agate, my brother Eric's wife was in a terrible accident in 2002. Her legs were crushed and she went through I think 13 surgeries during the next two to two and a half years in order to walk again. One leg is two inches shorter than the other one, but you can't tell it. For several years she was on and off pain pills, but as far as I know she has been completely off them for a long number of years. I think the only time she takes one is when she occasionally walks the whole golf course and stands all day in order to see their youngest son play in a tournament, especially when she does it two or three days in a row.

The only thing I have been able to find out about the pain that was so very bad in the beginning has come from their oldest son. Twice he has told me that she sometimes still has pain, but handles it differently. I don't know what that means. I had wondered if she went to some kind of pain management course (if there is such a thing). Neither she nor Eric seem to want to talk about it, so I don't push it with them. But something happened to cause my nephew to tell me that on two different occasions.

[agate]

Intractable pain like your sister-in-law must have had is very hard to put up with. I'm sure there are pain management courses as well as pain management clinics.

That's admirable that she walks the whole golf course. So many people just ride in those carts, don't they?

That must have been a really terrible accident.

[Virginia]

That accident was awful Agate. First they didn't think she would live, then they said she would never walk again. She with the help of a lot of family and friends proved them wrong. When I thought back the words my Nephew used both times he said that were "she manages it differently." So maybe she went to a pain management clinic or something. I just know she is one of the strongest persons in the family now, and I am talking about physically. She is the one who takes care of my Niece's baby and runs after him. She is always on the go and does everything. I think she is planning a trip to Boston to see their son play in a golf tournament next week. My brother will have to stay here and take care of the two dogs.

She used a golf cart when she first started back attending the tournaments, but has not done so to my knowledge in a lot of years. The reason she doesn't like to do that is because she likes to walk along with him, though not on the course with him, she is right up as close as she can get. A golf cart cannot get that close when there are hundreds and hundreds of people around.