Advice please!

Soheil Sulimani

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Hi guys,

I had a car accident 3 1/2 months ago and ever since I have had a problem with my back, left hip and left leg. The bottom left hand side of my back feels really tight and i get sharp pains into my hip at the front. Because of the pain I can not sit for longer than around 20 minutes or walk for too long without my left leg giving way undrneath me every 5 or so steps. I am seeing a chiropractor who has treated me for 12 sessions now and I am still no better. She did an xray which showed a twisted pelvis. My doctor sent me for a lumbar/ sacral mri scan and i have just got the results back. they are as follows:

The L4-5 and L3-4 discs show moderate degenerative changes unusual in a patient of this age (im 25)
The posterior aspects of both discs are prominent.
The axial sections show a central protrusion at L4-5 which is encroaching upon the anterior theca but is not resulting any significant neurological compromise.
There is a further central protrusion at L3-4 also not obviously resulting in a significant neurological compromise.

The specialist spoke to me on the phone and told me the results in his own words and I got a written copy of them today. He basically said he cant see why I am having the pains and said he will just send me for physio. To me it felt like he just fobbed me off and like I was making it up.

Does anybody know if the MRI i had can look at problems with the SI joint? I believe that is where my problems are. Also are the above results nothing to worry about like he made out?

Any help/ advice would be great!
 
Hello Mikeyr01.

Yes, I believe your suspicions are correct, the Specialist is almost certainly fobbing you off!!

Although the L 4/5 and L3/4 are described as not resulting in any significant neurological compromise 'and' not obviously resulting in a significant neurological compromise, I believe that these descriptions are flawed. I truly believe that you need a second opinion!

If the theca (sheath) surrounding the spinal column is noted as being encroached upon, while you are lying down in an MRI scanner, then it is totally reasonable to suppose, that under normal loading (standing up), then this ‘encroachment’ could well become a ‘compression’ of the Theca, and very possibly, of the spinal strands themselves. His dismissal of your description of your areas of pain, and of the MRI images themselves, is nothing short of crass!
(I assume that you have not undergone a dynamic (standing) MRI SCAN?)
I recommend that you try to find one in your area, pay privately if you can afford to (usually between £200- £600) Dynamic X-rays are also preferable.

Your symptoms are typical of an L 4/5 (sciatica) level nerve strand impingement, I know, I had the car accident, I went there, and I bought the t-shirt!! My Consultants also told me that my L5/S1 level lumber disc had a small bulge, a minor bulge, an insignificant bulge and it could not be causing any pain! After an operation to clear my L4/5 lateral recess impingement of my sciatic nerve root, it turned out that this insignificant bulge was causing me severe pains and was leaking disc (nucleus) material, which is also impinging my nerve strands, and causing pain!

Are you able to request a referral to a Spinal Surgeon of your choosing? Can you afford to go private? If you are, make sure you research the Surgeons in great detail, ask the HP forum members who are living in your area for recommendations.

Regarding the S I joint issue, ask your Chiropractor or Osteopath to specifically check out the rotation, and other directional movements of the S I joint, my Osteopath was great at dispelling my concerns about my S I.

All the Best

SPINELF
 
Hi SpineElf,

No I have not had a standing or seated MRI scan and I am almost certain that this would hi light alot more issues where the nerves are concerned.

Do you know if the NHS offers this atall? I personally cannot afford a private one but wonder if I could get one through my legal cover after the car accident.

Thanks
 
Is the case ongoing? Everyone leapt on the fact that I had had a minor shunt in a car, saying they could charge the other driver's insurance for everything, so ask them. I replied to the NHS part on the other thread
 
Hi Cas,

thank you for both of your replies.

Yes it is still ongoing. It happened in feb and I have been off work ever since. I had 5 osteopath sessions and so far had about 18 chiropractic sessions and still no better. Jut waiting for nhs physio at the moment.

I am £4000 out of pocket in loss of earnings and medical expenses and yet to receive a penny from the other driver so very much doubt that I would be able to claim for a different mri scan.
 
Hi Mikey, SORRY FOR THE DELAY!

I have found only 2 DYNAMIC LOAD BEARING MRI SCANNERS in the UK;
London - The London upright MRI clinic (a Leeds clinic opening soon)
Scotland - Aberdeen University.

The cost of the London scans are around £900 - 1 part, £1300 - 2 parts,
and £1500 - 3 parts.

If you can make the case that standard MRI's are not showing an accurate image that Surgeons can use, you may be able to push your insurance for it. You will still need to be referred by a GP or Surgeon.

Best of luck and best wishes.

SPINELF
 
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