Ganglion pressure & intra..osteophytes/fixable?

[ans]

Noted on MRI lateral recess and mild formanial stenosis w/osteophytes. Does this mean eventually these areas will be blocked/claudication?

1) If so, can this be "fixed"/osteophytes reamed and stay that way for an ADR or fusion?

2) Finally, if "neural elements" are encroaching upon the L2 ganglion distal to the foramen, does this mean that an ADR or fusion could not take care of this (guessing) pain generator?

Thanks, Allan

[tmont]

Allan,

No clue whatsoever on #2 and don't know if your #1 resembles mine, but here's what I was told on my osteophytes and foraminal stenosis:

'Likely' to evolve and cause blockage and nerve problems, but no way of knowing for sure. When I asked about removing the osteophytes prior to my percutaneous nucleotomy, the surgeon told me he'd 'scrape them' so they wouldn't cause any more trouble. This was a failure, although I can't vouch for the seriousness of the attempt as his priority was the soft hernia.

Was told afterwards that removing osteophytes wasn't an option outside ADR or fusion, but that they would be completely removed during either of the two procedures and 'theoretically' should not grow back if the job and healing take place correctly.

Trace

[Alastair]

Hi Allan,
the spinal cord goes through a hole in each of the spinal vertebrae. Stenosis is where this hole starts to get smaller and might impinge upon the formena. Unless there's real evidence of this hole getting smaller, I would guess it's not a problem to be addressed at this time.

As for osteophytes etc, if they are not a problem quite often it is a good idea to leave them alone. Many an osteophyte has been removed, only some years later to see a bigger and better osteophytes in its place. That is all clinical judgment.

[ans]

Thanks folks. I found this post by Justin re: stenosis; didn't know facet degeneration could drive this:

http://adrsupport.org/eve/forums/a/tpc/f/7501036081...411067081#1411067081

I wonder if you take out the canal that encases the nerve, will it flop around and get into trouble?

Still hunting for one post that mentions nerve root ganglion and I think a reference to failed back surgery. Hope I'm wrong..

Allan

[ans]

It'll be more of a hunt re: nerve root ganglion, surgery, is it a gain generator, how treated, etc. I guess it's something that's not removed.

Chirogeek has something - somewhere.

http://www.chirogeek.com/

[Ryan]

ANS,

Hi - I'm not sure if you remember me from the BPSG MB? Anyway, I'm one of the lucky ones that have experience with the root ganglion. I had a disk fragment from a lateral herniation that was contacting the dorsal root ganglion outside of the L5 neural foramin. surgery in my case to remove the fragment improved condition (leg pain) but some still lingers. the root ganglion is an extremely fragile area and unforgiving. I was told that what pain I have today is most likely permanent and somewhat concur since it's been 2.5 years since my surgery.

to respond to your question...I'm not sure if ADR would help or not. Also, what do they mean by "neural elements" from your MRI report. Is this chemical irritation from the disk?

[ans]

Hi Ryan,

I do remember you and even your posts here (it helps to look 'em up).

Sorry you're still in pain (hope not too much) and that nerve root ganglion's have been a hobby.

Good question re: neural elements. I'll ask my doctor to review my MRI. I doubt it's chemical irritation as my L5-S1 was totally dehydrated/blown.

Thanks for your time and be well. - Allan

PS Also thanks to the anonymous member who PM'd me an article indicating that the dorsal root ganglion is indeed a pain generator, treated by a formaminotomy.