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Compression Fracture of L4
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debs_bears posted:
What do they do for a compression fracture of the L4 - sometime between April 20th and May 13th I broke L4 trust me I knew something was wrong I felt a pop and hurt for almost 2 weeks and it kind of died down. I just thought it was a pulled muscle. So I went about my business had my ostomy surgery and then now the new in my lower abdomen. My surgeon thinks it is referred pain.


I been having pain in my lower abdomen so my colon surgeon thought it was another hernia and ordered a double contrast Ct-scan. Got the call yesterday afternoon 3 hrs after the test telling me I have too much air in my stomach enlarging it and the new finding of this compression fracture.


The strange thing is I saw my neurosurgeon for my check up on April 18th and all was fine. DDD and facet disease were mildly changed, scoliosis slightly changed. Basically no need to come back for a year.


My colon surgeon is sending back to my GI doc for more tests of my stomach apparently this problem is getting worse since Feb.


Now my colon surgeon is referring me to a new Neurosurgeon for my L4. I also have lost 25% space between the vertebrae. Apparently having scoliosis, osteopenia and spondylitis with this fracture is not a good combination they are telling me.


Thanks for reading.
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~
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trs1960 responded:
Did they mention Levoscoliosis or just the broken L4? Where is L4 fractured? Transverse process, spinous process, body, pedicel, superior articular process?

It would really matter where the fracture is. I fractured many more vertebra that were outside of the actual surgery, doc said we'd be better off leaving them alone.

Those were spinous and transverse process fractures.

I'd worry more about the disc degeneration...well, I'd want answers for both!

Best of luck.

God bless,

Tim
 
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debs_bears replied to trs1960's response:
Hey Tim I hope I can answer your questions.


April's x-ray says: increased changes with DDD L4-5 and L5-S1 with facet arthropathy at L5-S1. I do have s shape scoliosis, spondylitis of the cervical and thoracic as well as thoracic kyphosis. Multilevel disk space narrowing with tiny endplate osteophyte formation.


Ct-scan yesterday says: new compression of the superior endplate of L4 has developed since the patient's prior study of Feb. 12, 2014. There is approx. 25% loss in height of the L4 vertebral body.
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~
 
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trs1960 replied to debs_bears's response:
As do I...my cervical is in pretty good shape, but it's starting to have issues. The spinous process at T4-T7 were crushed and disfigured both with kyphosis and lateral disfigurement. Below that it gets worse. Vertebra that were once individual bones are now only distinguished by a line on the MRI images. L2 is now in two pieces with a complete break about the longitudinal axis. T10 also has a fracture of the body looking like a tall tilted V.

So I see the words compression of the superior endplate, to me that's a compression of the vertebra causing 25% loss of height in disc space...

Osteophyte Is typically bone spurs. These along with general DDD each can be quite painful in their own rite. Thoracic impingements can damage nerves feeding your internal organs and facet anthropathy typically describes an arthritic condition, but the question is specific to an L4 fracture, yet the word fracture is never used again.

I say this because I have many fractured and broken vertebra, a bone fracture of the vertebra if not posing risk to the CNS or SNS is in my opinion less to worry than the rest of the picture.

Did they say bone fracture or vertebral compression fracture?

I'm really curious. As I said, I have many broken and fractured vertebra so I'm trying to find something I can relate empirically.

With all respect,

Tim
 
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debs_bears replied to trs1960's response:
Tim sorry for your back issues as well.


What my back told me on the phone was: the radiologist called her at home telling her I have is a compression fracture of the L4. It is not written like that on the report but on the scan it was pointed out to me that the L4 is broken.


My entire right leg is also being effected by it now. My colon surgeon is getting me into a new neurosurgeon asap.


Thanks again for your help. Debbie
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~
 
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trs1960 replied to debs_bears's response:
Ok, now I got it. I still go back to what I said. As long as the bone is not putting nerves at risk I think it to be the lessor of your problems. You got some real owies going on, if it's just a fracture there shouldn't be any bone displacement . It appears (IMHO ) that's its effect and not cause. You have a lot going on. Have you had a bone density scan? It seems that the force of L4 being forced downward may have fractured it if the bones are in a weakened state...that scares me.



The arthritis in the facets could be extremely painful if they impact the ganglia.

I wish I could post pictures. I could show broken vertebra that would make your blood curl, but they don't bother me. My biggest problem is the broken spinous process causing muscle pain from damaged muscle attachments. FWIW, I had vertebral fractures they just ignored. They healed on their own.

I winder if you digestive issues are an effect of thoracic nerve impingement?

Of course I don't know the underlying issues, you've got a lot going on and it's not so simple as to discuss the fracture in a vacuum.

God bless,

Tim
 
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trs1960 replied to trs1960's response:
When I say the fracture doesn't scare me doesn't mean I'm writing off L4. The fact that it's being forced down so hard as to causes it to fracture puzzles me. The fact that it's compressing the disc bothers me. As I said above, I see the fracture as an effect of another problem. That's why I asked about bone density or bone disease?

God bless,

Tim
 
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debs_bears replied to trs1960's response:
Yes bone density test was done 2 years in a row 2012 it was -1.55 osteopenia, in May 2013 it was -2.00 so they increased my calcium and Vit. D3 Medicare says I now have to wait until May 2015 to be retested cuz I wasn't at the osteoporosis point. That number needs to be -2.50.


My digestive issues were caused by a autonomic dysfunction from the vagus (sp) nerve in my brain. It began shutting down all my organs and my diaphragm. I also had pan-colonic hypo-motility which caused my intestines to quit working direct result of my autonomic dysfunction.


Right now I am a little abby normal and the tests results on everything are coming back abnormal.
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~
 
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trs1960 replied to debs_bears's response:
That's kind of what I feared .

I'll keep you in my prayers.

Your friend,

Tim
 
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debs_bears replied to trs1960's response:
Thanks Tim


My Neurosurgeon's office did call me back today and said that I have to be seen by someone soon and wanted to know what was happening - I told them that since Dr. Hz really doesn't work on the lower spine I will trust my colon surgeons opinion. She said so what kind of doctor are you being referred to? I said a neurosurgeon she said good - an orthopedic isn't someone who can help right now. So she gave me blessings and said make sure you keep the appt.


So I am guessing based on these comments this is a serious matter.
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~
 
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trs1960 replied to debs_bears's response:
Let's hope not. Pray the best, prepare for the worst and you will be somewhere in between.

I just hope it's facet and compression issues impinging your nerves so it can be fixed. I can understand that. I don't understand the brain interface with the nervous system. I get the anatomy, but the function of the brain and nervous system is so complex it boggles my mind. I've studied axons, dendhrytes, synapses etc, but I've yet to understand their dynamics.

God bless,

Tim
 
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trs1960 replied to trs1960's response:
As I said, I really do have vertebra that were so crushed the only delineation on the MRI is a line between them. Many a doctor has shaken his head in wonder as to why I can even walk? I just looked at them again and what really amazes me is there are no Facets. How can the nerves exit the spinal column when there is 100% compression between vertebra?

God works in mysterious ways, never lose faith.

With kindest considerations and prayers,

Tim
 
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debs_bears replied to trs1960's response:
I am sorry for all you back issues - is the pain pump able to help alleviate those pains?
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~
 
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trs1960 replied to debs_bears's response:
My back issues are not your fault. Its what happens when tons of mass accelerating a 32ft/s/s (gravity) hits a human body.


Where I'm at id best described in the letter I sent my doctor last week. I can't paste images here, but suffice to say I have an anatomical picture of the muscle group in question and a snapshot of the relevant section of my MI.


Letter:




June 9, 2014


I've been listening to my body and it is talking to me. The pump works great from T5/6 down. With everything from that point down in check, the old upper thoracic pain is what still hurts (Gate Control Theory- Patrick Wall MD and Ronald Melzack PhD.). The reason I questioned the Boluses being a placebo is (I believe) the analgesic is just not reaching T4/5. Or its muscle pain and the analgesics in the spinal fluid are ineffective?


Here's my logic:


Anatomy of Splenius Cervicis.
MRI:




The pain comes from holding my head up. It seems I can feel the SC base muscle attachments, that's what I have always described as a deep pain. Like a 2x4 is being driven through me. When really aggravated I can feel the muscle group all the way up to the skull attachments, effect not cause.


I'm certainly not a trained radiologist, but I remember Dr. Jones talking about the carnage and that my back looked like a battlefield wound. You can see the kyphosis, and lateral disfigurement.


Prior the pump install there was a dialogue that mentioned the specific gravity of the analgesic could be altered with respect to the spinal fluid. Is it possible to try and decrease it for more elevation? Will it even have efficacy on muscle pain?


Not looking for intervention, just planning for next visit in July.


Regards,
Tim



 
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debs_bears replied to trs1960's response:
I realize your back isn't my fault I can still feel sorrow for what you are going through.


I can't imagine all that happened to you - I will pray that your well reversed letter will get the point across.


Does the pain pump work like the SCS that depending on where it is located determines where it will work? The reason why I ask is when I had my SCS it was placed low in my back so it only worked on my legs. I was told the higher they put it the more the area it works on. Just curious. I do hope you get better results higher up. Debbie
It is my prayer that you have a Blessed Day in all that you do. ~~~Debbie~~~


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