Should My Doctor be Doing More?


Q: I am a vet who sustained a back injury while in iraq. I have been through every conservative method of pain control and nothing has worked. Recently I had an MRI done of my lumbar area. After the test I went to see my provider and he said that all the findings were normal. Here is what the findings actually said: There is a somewhat mottled appearance with thickened area of soft tissue posterior to the L3-L5 vertabral bodies and intervertebral disc space levels. This appears to be extradural and could represent ossification of the posterior longitudinal at these levels. There does not appear evidence of significant thecal sac effacement. If these are flow voids, a rare paraganglioma is also on the differential. I did some reasher on the ossificaton of the longitudinal and the paraganglioma. My question is, should my doctor be doing more to find out if I do actually have this tumor?


A:   Depending on the size and localization of the paraganglioma surgery can be considered to avoid nerve compression, according with the description of the MRI is not sure that there is in fact paraganglioma neither ossification of the posterior ligament. The report of the MRI is not conclusive.
The suggested strategy would be: ask for a second opinion of a spine surgeon.  He or she will be able to tell you if surgery is an option. If surgery is not an option, then the best method would be to try different froms of physical therapy. Not all people respond to the same treatments.  Treatment options include accupuncture, chiropractic therapy, active release therpy, and phsiotherapy. Regardlesss of the treatment option that works best for you - a routine of regular strengthening and stretching of core muscle groups will be required.

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