Patient : I was seen at a local Hospital recently for severe back pain which radiated to the front causing slight chest pains. I was cleared cardiac however I did still see a Pain Management Person whom gave me a Facet Joint Block and a Caudal Block. Even from the first placement of the needle the pain immediately worsened. I attempted several times to notify someone at the Pain Management persons office and was put off repeatedly.
I returned to the Emergency room two days ago and received a C.T. scan The pain however has become much worse and I have been getting a very large black and blue upon my right flank. I can not sit, nor stand for more than five minutes or the pain knocks me down. I have been slightly incontinent upon flatulence.
I would like your permission to go to the E.R. and begin a relationship with someone there. Any neurosurgeon will do, I need help fast please, I can no longer stand this pain. I realize I am not the only patient in the world but I really need some help please.
Thank You for your time and attention to this matter.
Findings: There is straightening of the normal lumbar lordosis, with 5mm of grade 1 retrolisthesis of L5 on S1 associated with decreased invertabral disc height, marginal osteophyte formation and vacum disc phenomena. There are also mild degenerative changes at L2-L3 through L4-L5 where there also appears to be 2mm of retrolisthesis at each of these levels. No destructive bone lesion or acute fracture is identified. Mild sclerosis is noted at the sacroiliac joints.
Mild braod-based disc bulges are identified at L2-L3 through L4-L5 for which the spinal canal appears to be narrowed to 8 mm. No neural foramen narrowing is seen. However there is a large broad-based disc bulge with a right paracentral component that impinges upon the right L5 nerve.
No retroperitoneal adenopathy is identified. There is a 4mm right renal calculus.
1 No acute osseous finding.
2. Multilevel mild degenerative changes and grade 1 retrolisthesis most severe at L5-S1 where there is a posterior disc bulge with a right paracentral component that compresses the right L5 Nerve. As there also appears to be multilevel mild spinal canal stenosis due to disc bulges.
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