Lumbar Spine problems

[dashez]

My recent mri scan reveals the following:
There are multiple endplate irregularity type changes in the lower thoracic spine which may indicate a degree of old sheurmann's disease.
There is a focal right paracentral disc herniation at the T11/12 disc which indents the right half of the lower spinal cord.
There is no signal change within the cord however and adequate csf surrounds the cord at this level.
There is severe congenital spinal canal stenosis between L2 and L5 with short pedicles and flattened laminae.
At L2/3- there is a broad based posterior disc bulge which is causing further narrowing of the spinal canal. The cauda equina fibres are crowded within the thecal sac and no csf is seen surrounding the fibres.
At L3/4- there is a focal central and right paracentral disc herniation on top of a couple of broad based disc bulge. This is indenting the right half of the thecal sac which has crowded cauda equina fibres within it. No csf seen surrounding the sac but there is a small amount of epidural fat.
At L4/5 there is a focal central disc herniation on a couple of broad based posterior disc bulge. Again, this is causing marked spinal canal stenosis although some epidural fat is seen surrounding the thecal sac, the cauda equina fibres are again crowded with no csf surrounding them.

At the moment I am experiencing claudication due to the above.
My question is?
Will they operate?

[medicalmom01]

I also have spinal stenosis and degenerative disk disease.  It will never get better.  Epidurial injections didn't help and only masked the situation and only lasts 6 month on a good day. Surgery will probably be your only option, depending on your level of pain. I am in pain every day for 6 yrs and took ibuferon  for 6 yrs each day, and messed up my kidneys.  Only Tynenol can I use now.  Anyway,   Check into to this new procedure called micro endoscopy spinal surgery.  It's out patient, lasting 90 min and you go home the same day.  Check out Dr's who do this and make sure they are Board Certified.  I know Duke University in Durham NC, has Micro Dr's and there is one in Seneca SC.  I just had an MRI (lumbar) and am going to have the procedure done.  I can't walk very long distances or be on my feet very long.  Plus the siatica nerve bothers my right leg when walking.  Check this out, you could get some relief..

[bellir]

I read that removal of spinal fluid (for tests) can cause glaucoma. I don't have any high eye pressure and still my optical nerve has problems.

If the spinal fluid removal (many years ago) really lowered the spinal fluid pressure causing glaucoma, then what can I do to compensate that? Are they are pills or treatment for that?
bellir

[Craig Brooker]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

First let me explain why I can't fully answer your question, then allow me to tell you a few things that might be helpful for someone else to be able to answer your question.  As neurologists, we treat the medical side of neurological disease.  Neurosurgeons do neurological surgery and while neurologists often refer patients for neurosurgical evaluation, the neurosurgeons themselves decide if they would operate.  And of course different neurosurgeons have somewhat different thresholds and opinions regarding what they would or would not offer surgery for.  An imaging report is only 1 of many factors surgeons consider.  They will want to look at the images themselves, understand your clinical course (e.g. the degree of disability, acuity/chronicity, etc), and do a clinical exam to help corroborate the image findings.  They will also want to look at your comorbidities to help determine how well you might tolerate surgery.  

The read of your images also suggests congenital stenosis.  Truly understanding the time course of your symptoms, their severity, and how this effects your activities of daily living may all be important.  All that said, sure, severe spinal stenosis can be serious and may require surgery, dependent on all of the above factors.