L5/S1 Sequestrated disc
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L5/S1 Sequestrated disc
Had an MRI scan which suggested "There is severe compression of the transiting S1 root"
Having had a period of back / leg pain and numbness of part of the foot I am now pain free (but can just about touch my knee caps before something stops me ...not pain).
Is this restriction to movement likely to stop my medical being renewed?
The neurosurgeon is keen to operate but I am not sure if the sequestrated disc is "spinal stenosis" 1 in 350 deaths or "slipped disc" 1 in 700 deaths.
Really interested in thoughts / advice / experience. I have not yet tried Pilates ....and the surgeon also said the disc fragment could dissolve /be absorbed by the body in five years.BTW My age is 59 (finger trouble on initial set up)
Having had a period of back / leg pain and numbness of part of the foot I am now pain free (but can just about touch my knee caps before something stops me ...not pain).
Is this restriction to movement likely to stop my medical being renewed?
The neurosurgeon is keen to operate but I am not sure if the sequestrated disc is "spinal stenosis" 1 in 350 deaths or "slipped disc" 1 in 700 deaths.
Really interested in thoughts / advice / experience. I have not yet tried Pilates ....and the surgeon also said the disc fragment could dissolve /be absorbed by the body in five years.BTW My age is 59 (finger trouble on initial set up)
Last edited by Zoyberg; 2nd May 2017 at 11:19. Reason: age note
Psychophysiological entity
What's all this talk about death? Don't understand. Anyway, nothing worse than the living death of years of back pain.
It's all about your trust in your surgeon. I finally found someone that would crack on with the job after pleading and being refused for well over ten years with a slew of surgeons. One wouldn't even see me, just referred for pain control. One year wait. Total B#@$%#. Written off because of age I suppose.
A couple of years ago I went to a Suffolk hospital, soon admitted and 36 hours later he said, go home.
I power-walk a couple of miles a day now including a lot of cliff steps.
That formally springy goop in disks gets more like dried crab meat in older folk. I'm not at all sure it just dissipates so conveniently. Anyway, it's often the tough edges of the annular tear that are irritating the nerve.
Having said all this, if you're without pain you might try what I used to do and just stand beside a table or railings and press up, with the item pressing into your gut just above your nuts. I'd do that dozens of time if working hard on the house and garden. When I asked a senior neurosurgeon if stretching like that would draw the spongy material back into the disk, he said, That's
He'd been much more polite when I saw him privately.
Whatever, it felt good and I've lost less height that all my previously taller friends - by several inches. Over many years I've concluded: gentle traction is good. Pulling unknown damage around by 'experts', bad.
Quite a good shutterstock pic.
https://www.shutterstock.com/image-i...hSv7i0v8Q-1-24
It's all about your trust in your surgeon. I finally found someone that would crack on with the job after pleading and being refused for well over ten years with a slew of surgeons. One wouldn't even see me, just referred for pain control. One year wait. Total B#@$%#. Written off because of age I suppose.
A couple of years ago I went to a Suffolk hospital, soon admitted and 36 hours later he said, go home.
I power-walk a couple of miles a day now including a lot of cliff steps.
That formally springy goop in disks gets more like dried crab meat in older folk. I'm not at all sure it just dissipates so conveniently. Anyway, it's often the tough edges of the annular tear that are irritating the nerve.
Having said all this, if you're without pain you might try what I used to do and just stand beside a table or railings and press up, with the item pressing into your gut just above your nuts. I'd do that dozens of time if working hard on the house and garden. When I asked a senior neurosurgeon if stretching like that would draw the spongy material back into the disk, he said, That's
He'd been much more polite when I saw him privately. Whatever, it felt good and I've lost less height that all my previously taller friends - by several inches. Over many years I've concluded: gentle traction is good. Pulling unknown damage around by 'experts', bad.
Quite a good shutterstock pic.
https://www.shutterstock.com/image-i...hSv7i0v8Q-1-24
Last edited by Loose rivets; 2nd May 2017 at 15:14.
Zoyberg, I recommend you go and sit down with the neurosurgeon, ask him to show you your MRI and explain what is wrong and what he proposes.
The nerve is being squashed. Sometimes it can be by a bit of bone but normally by a disc protrusion. As your surgeon has said, it will probably eventually get better as the disc dries out and shrivels, but meantime you have issues
I am not an AME but normally I gather they are happy so long as you can demonstrate mobility - normally touching your toes etc. If you cant move for pain, then I suspect they might worry you cant fly. All common sense
You may benefit from injections of local anaesthetic and steroids but the definitive operation is to remove the disc. The death rates you mention would be extreme for the most primitive third world hospital. I would list it around 1 in 83,000. Spinal stenosis does involve releasing multiple nerve roots and there is a small risk of temporary or permanent damage, but you most likely have a disc problem. Again your surgeon will go through the risks and their frequency
Good luck
The nerve is being squashed. Sometimes it can be by a bit of bone but normally by a disc protrusion. As your surgeon has said, it will probably eventually get better as the disc dries out and shrivels, but meantime you have issues
I am not an AME but normally I gather they are happy so long as you can demonstrate mobility - normally touching your toes etc. If you cant move for pain, then I suspect they might worry you cant fly. All common sense
You may benefit from injections of local anaesthetic and steroids but the definitive operation is to remove the disc. The death rates you mention would be extreme for the most primitive third world hospital. I would list it around 1 in 83,000. Spinal stenosis does involve releasing multiple nerve roots and there is a small risk of temporary or permanent damage, but you most likely have a disc problem. Again your surgeon will go through the risks and their frequency
Good luck
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MRI
Hi Radgirl / LR
Thanks for the responses...below are my MRI shots
Radgirl
Will speak to the Neurosurgeon and get more info here are the photos of my MRI .....he identified the offending sequestrated disc above the arrow. I am not sure if this is a piece of bone (which presumably would be less likely to dissolve / be absorbed than a bit of disc?
Don't even know if the above counts as "spinal stenosis" or the much less risky "slipped disc" The death rate seemed extreme to me and came from the general NHS risk sheet on lumbar decopmpression surgery (if this applies to me)?.
Lumbar decompression surgery - Risks - NHS Choices
I can't touch my toes (just about reach my knees but) but I can reach everything in the cockpit pain free. I am actually pain free all the time now(following a month of serious discomfort at the start of the year).
LR
When you say pulling unknown damage around by experts ...may I ask if you had an op that didn't go as well as you hoped?
Thanks for the responses...below are my MRI shots
Radgirl
Will speak to the Neurosurgeon and get more info here are the photos of my MRI .....he identified the offending sequestrated disc above the arrow. I am not sure if this is a piece of bone (which presumably would be less likely to dissolve / be absorbed than a bit of disc?
Don't even know if the above counts as "spinal stenosis" or the much less risky "slipped disc" The death rate seemed extreme to me and came from the general NHS risk sheet on lumbar decopmpression surgery (if this applies to me)?.
Lumbar decompression surgery - Risks - NHS Choices
I can't touch my toes (just about reach my knees but) but I can reach everything in the cockpit pain free. I am actually pain free all the time now(following a month of serious discomfort at the start of the year).
LR
When you say pulling unknown damage around by experts ...may I ask if you had an op that didn't go as well as you hoped?
I carried on flying for ages with a much worse MRI picture. I could touch my toes but not get back up and the AME finally pulled the plug when I couldn't demonstrate getting up fast from a cross-legged position. I could open aircraft doors etc but not walk up stairs without difficulty. I tried the injections but they only lasted for a few weeks. After finally getting the big Op I returned to flying after about 12 months, poorer but wiser and healthier. Unfortunately I suffered some nerve damage to my right leg which eventually finished me off. Maybe if I had taken the surgical option sooner...
Aged 40 when it happened, 48 now and permanently knack'd
Aged 40 when it happened, 48 now and permanently knack'd
Psychophysiological entity
Gosh, Blue, that really spells out what real surgery is like. So easy when looking at Gray's Anatomy. Was there a single reason it got like that?
Zoyberg
I should be more precise when on the serious forums, but what I said had those two vital ' ' s around experts.
I'm still angry about a house full of 'Doctors' in a nearby town, and I've discussed before on PPRuNe the medical qualifications of some folk trading as doctors in the UK (that have qualified in other countries.) Having said this, they do have to work long and hard for that qualification, but it's nothing like becoming a UK neurosurgeon. Anyway, two different ones just followed others by launching into the same old pull twist, pull twist, PRESS, that I'd had a hundred times - well, 20, perhaps at around 80 quid a go. Total and absolute waste of time and money. My wife by then could do a far better job of crunching me back into shape and I could be back doing heavy DIY in a few minutes.
Let me say here, my problems were bought about by my obsessive desire to do building work and a mindset that said, if it won't move, go past red-line until it @#$%# well does. There comes a time when the inner workings won't play ball anymore. At 61 years old, my lovely girls were carrying their poor old skipper's flight bag.
Your MRI doesn't look at all bad apart from that one place that really stands out. I'd want that gone.
It's a funny thing, but once past the last Sciatic nerve, so much of the spinal cord's function becomes simply supportive and it might be just a case of getting rid of that bulge and you'd be as right as rain.
The bit that my surgeon worked on was not as clearly defined as that but the rest of my lower spine was nowhere near as good as yours. When my surgeon said go home, I did, and the only restriction was not lifting heavy weights.
Zoyberg
I should be more precise when on the serious forums, but what I said had those two vital ' ' s around experts.
Pulling unknown damage around by 'experts', bad.
Let me say here, my problems were bought about by my obsessive desire to do building work and a mindset that said, if it won't move, go past red-line until it @#$%# well does. There comes a time when the inner workings won't play ball anymore. At 61 years old, my lovely girls were carrying their poor old skipper's flight bag.
Your MRI doesn't look at all bad apart from that one place that really stands out. I'd want that gone.
It's a funny thing, but once past the last Sciatic nerve, so much of the spinal cord's function becomes simply supportive and it might be just a case of getting rid of that bulge and you'd be as right as rain.
The bit that my surgeon worked on was not as clearly defined as that but the rest of my lower spine was nowhere near as good as yours. When my surgeon said go home, I did, and the only restriction was not lifting heavy weights.
A surgeon is likely to offer......surgery.
Explore all the options. Take into account risk/benefit etc.
Scans are important, but functionality more so.
The scans you've posted are unlikely to be predictive of prognosis.
Explore all the options. Take into account risk/benefit etc.
Scans are important, but functionality more so.
The scans you've posted are unlikely to be predictive of prognosis.
+1 on that. Pilates worked well for me post-Op in improving the range of movement but you need to make it a daily exercise to benefit fully. Amazing how much my flexibility improved. On my course I was the youngest person there by about 25 years but it became quite a fun experience since none of us were Gym Bunnies with rippling muscles.
Planking is another great exercise to shore up the core muscles without antagonising the back.
Planking is another great exercise to shore up the core muscles without antagonising the back.
