Compression Fracture L4 Bone scan and CT Scan 
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 Compression Fracture L4 Bone scan and CT Scan

I was involved in an auto accident 6 years ago. Never had back pain in
my life (I am 49) until the accident. I have no ulterior motives in
asking this question such as any pending lawsuits. I am just trying to
understand the injury I sustained and get an idea of my prognosis and
what I need to do to manage my care

MRI a few months after the accident revealed a "septic discitis" (no I
am not an IVDU or immunocompromised) but this was later thought to be
a compression fracture of L4 with partial collapse of the anterior
vertebrae. I was in an auto accident with an older woman who was
stepping on the gas instead of the break. Instinctively, I went to put
out my hand out toward the break in a futile attempt to push my hand
on the break. Of course I could not reach. As I made that forward
motion and was on my way back to an upright position, , that is when
she hit a tree head on. My head went through the windshield. I was not
restrained because she took off like a bat out of hell out of her
driveway and I did not have time to put on my seat belt.

I used to have pain radiating to my right leg but more recently I have
only been getting pain in my left hip, numbness on the anterior part
of my lower leg and pain to the left ankle. Any increase in activity
increases pain. I do stretching exercises.

Recent CT scan showed

L3-4 mildly asymetric diffuse  disc bulge, causes minimal compromise
of the inferior aspect of the left neural foramen. Although this
causes partial effacement of the fat anterior to the exiting left L3
nerve root, no definite nerve root impingement is suspected. Facets

L4-5 Minimal end plate osteophytes are present along with hypertropic
changes of the facets, left greater than right, this contributes to
moderate narrowing of the left neural foramen. the hypertropic changes
do abut the exiting Left L4 nerve root. There is no significant disc
bulge or focal disc protrusion

L5 S1 Subtle right paracentral broad based dis bulge which may cause a
partial effacement of the fat anterior to the right descending S1
nerve root. No definite impingement is suspected. Intimal endplate
osteophytes are present, particularly on the right which causes
minimal neural foraminal compromise along with its inferior aspect.

The scout image is notable only for a minimal wedge like deformity of
the L4 vertebral body along the superior end plate.

Would these findings cause chronic pain?

Are hypertrophic changes related to the aging process? Osteoporosis?

What amount of weight should I be able to safely lift on a regular

What are osteophytes? Are they part of the aging process or something
like gout of the spine?

I have tried NSAID's but they give little relief. I am not one to take
narcotics. I have also tried prednisone (5 day course) but that did
not help either. In light of the failed response to {*filter*}prednisone,
would this be predictive of how I would respond to spinal injection of
prednisone or other steroid? Also, is an MRI done before they give
someone a spinal injection of prednisone or other steroid?

I am concerned the other vertebrae adjacent to the one that is
partially collapsed, will collapse or that the rest of L4 will
collapse. Is this possible? I am overweight, yes I know I need to lose
weight but its hgar exercising when you are in pain and cant stand for
long periods of time.

What would be the most definitive diagnostic test be to monitor the
progression of what I have or will it not progress?

How often should I have diagnostic testing done?

Is a CT or bone scan more specific for a fracture of L4?

Could I benefit from vertebroplasty?

Thank you so much

Fri, 25 Mar 2005 10:37:05 GMT
 [ 1 post ] 

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