Need some help please

mimi427December 10, 2005

I found out yesterday (after having an MRI) that I have a synovial cyst that has formed on the lumbar portion of my spine (L5/L6), and it is pinching the nerves there, causing severe pain going from my lower back, into my right hip and down my right leg. My doctor called to discuss the results of the MRI, and tells me she has already put a call into an orthopedic spinal surgeon, which completely freaked me out. At this point, I do NOT want to rush into surgery, but I will keep the appointment, if for no other reason than to have a second opinion on the MRI, and to ask him what my options are. I have read on the internet (and we all know you cannot believe everything you read there) that my options are: cortisone shots, epidural injections, and two different surgeries. I'm wondering about acupuncture, massage therapy, or chiropractic?

I would love to hear from you if you have any information on this. I'd also like to know your opinion, if I do choose surgery, why choose an orthopedic spinal surgeon over a spinal neurosurgeon when having spinal surgery (my doctor is sending me to an orthopedic spinal surgeon) What really bummed me was I read that normally these synovial cysts develop after age 65...I am 54... I'm beginning to wonder if all the exercise I have done throughout my adult years is now taking its toll on my back. I know everything you read and hear tells you how good exercise is, but I just wonder... I trained for four years in Karate while in my 30's, including sparring (fighting) where I did take kicks to my back (yes, a missed block). While going to karate, I trained 4 nights a week and Sats. I also was a fanatic about the Stairclimbing machines at the health club. Not the ones that you peddled up and down on, but the big machines, with actual steps that you climbed and you could set the speed. I'd do those for 90 minutes before work every day. In fact, I entered a race and climbed the stairs of the John Hancock building (94 floors). Then in more recent years, I've been walking, either treadmill or outside, mainly outside, on average of 2 to 4 miles a day. I've always had Golden Retriever dogs, - very high energy... so it's always been a big incentive for me to get out and walk. I've had back pain for years, but never quite like this...I just can't help but wonder if I did myself more harm than good...

Any information would be appreciated.


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Mimi, that's a growth that you have. None of the other treatments will reduce the size. Nor do you want to run the risk of it growing.. The steroid shots MIGHT stop or slow down the growth. Maybe even strink it. Epidural shots will help the pain, but the growth is still there pressing on your spine.

    Bookmark   December 10, 2005 at 11:52AM
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The reason that your doctor picked an orthopedic spinal surgeon rather than a neurologist is that this is primary a bone problem. However, the main thing is getting someone that you feel comfortable with. Don't worry about things you have done in the past. This probably happens to the lazy couch potato too. It could cause permanent damage to your spinal cord. You really, really don't want that.

    Bookmark   December 10, 2005 at 12:02PM
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Thank you for this PB??? Frog?? I don't recognize the screen name, but looked at "my page" and thought you might be the very wise PB that I have grown to know and admire.
I read and re-read your response... are you saying you think my choices are limited to surgery? Do these cysts ever dissolve on their own?
I did read that they are rare on the spinal column, usually appear in different areas of the body. Oh boy, my head is spinning right now. Although the appt is just two day's away, I'm anxious for answers right now...never been a very patient person.
PB, (if you are PB) are you in the medical field? I know you are a wealth of information, just wondering if it's from all the reading you do, or if you have a medical background...
I did talk to the doctor that I work for today. He is a surgeon, but he's a GYN - he does advanced endoscopic, minimally invasive and robotic procedures...obviously, nothing to do with the spine. He was able to tell me he knows the doctor I'm seeing on Monday and he is "the BEST" in his field in this area (Chicago)... he is an orthopedic spinal surgeon who did a fellowship in spinal surgery, and his specialty is abnormal spinal surgery. In any case, I asked the doc I work for which way to go? Neurosurgeon or Ortho, if in fact I do go for the surgery. He said good question...then told me that he' set up an appt with a neurosurgeon he knows so I can get both docs opinions. In fact,he told me, these two doctors do surgery together at least once a week (they are on staff at the same hospital as the doc I work for). I didn't quite understand why, but it may be because of where something is located, as in this cyst, which is growing on the bone of the spine, but pressing or pinching nerves in the spinal column...???? As you can see, I'm making myself nuts...only good thing is it takes my mind off the pain....
thanks, Mimi

    Bookmark   December 10, 2005 at 12:26PM
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Yeah, it's PB. The why and wherefore of all the name changes are too many to go into. Maybe this will be the last. It's good to get second (and even third) opinions about anything that you are not sure of. Listen to those doctors. They may want to try steroid injections(or something else) first. The need is to reduce the size of the cyst so that it does not damage the nerve. Don't try to ignore it.

    Bookmark   December 10, 2005 at 12:55PM
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Okay, I saw the orthopedic spinal surgeon last nite. Only had to wait two hours to see him...I'm not good at waiting, but I guess getting in right away, I can't complain too much. He did not have the MRI films, just the written report. He said he'd have to see the films before given me a final recommendation, but based on the written report, and his exam of me (he didn't feel I have any nerve damage in my leg) he is recommending physical therapy and epidural (steroid) injections, but again, he needs to see the films to determine how big the cyst is and how much it is affecting the nerve.
He also went back and looked at X-rays I had taken in July, 2005. He told me I have degeneration of the disks at every level. In addition, there is herniation at several levels, the lumbar region being the worst area. So, no wonder I've had back pain for so long.
As far as surgery, he won't consider it unless I begin to have nerve damage (numbness in my leg, etc), or if he sees something else on the films. He said then he would take care of the cyst and possibly some of the other issues.
So, a lot of the meantime, I scheduled an appt with a neurosurgeon to get his opinion.

    Bookmark   December 13, 2005 at 1:34PM
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Hang in there Mimi. The more information on this, the better decision you will make. Did you feel comfortable with this doctor?

    Bookmark   December 14, 2005 at 9:50AM
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Yes, PB, I did feel comfortable with him. He was in no hurry and allowed me to ask all my questions -- guess that's probably why he is two hours behind. I'm just not sure what I'm going to do. Actually, the pain in my hip is subsiding and the one down my leg isn't too bad, so now I'm just not sure if I need to rush off to PT and injections. During the exam, he took my shoulders and bent me sideways, both right and left. Now I'm wondering if he could have "popped" the cyst, since the pain is subsiding?

    Bookmark   December 14, 2005 at 10:50PM
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more likely is that he 'nudged' it - cysts are usually only weakly attatched to whatever matrix they're growing in, or out of...

but whoo boy, yeah- no wonder you have been having back problems.

as to whether karate caused it- the 15% or so that may have been related to you taking blows or training too hard (I have a yoga instructor who has arthritis in her TOES from 'springing' into the downward-facing dog position ever day for 30 years) needs to be balanced against the superior bone density that you enjoy because of it, the stronger and thicker 'girdle' of muscles that has likely kept you from much greater injury, and the improved posture which also staved off back problems.

have known people in their 20's with these cysts, so 'more common' in the older people is only so relevant.

you might look into ultrasound to try and break up the cyst...

and definately talk to them about the calcium/maganese and glucosamine/chondriton supplements for your discs- I'm 110% recovered from two torn discs, and I credit my neurologist's combination of therapies for it.

    Bookmark   December 15, 2005 at 12:02PM
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when is our appointment with the neuro? Be sure and let us know how it turns out. Conservative treatment is always good, but sometimes it merely postpones the inevitable.
Take care

    Bookmark   December 15, 2005 at 9:32PM
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