请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
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请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
好不容易做了MRI,又要等3个月,才有下一个appointment。请感兴趣的大侠看看提提建议。多谢了。
MRI:
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MR LUMBAR SPINE WITHOUT CONTRAST: 10/12/2023 9:44 AM
INDICATION (as provided by referring clinician): Low back and leg pain, 6 weeks or more
TECHNIQUE: 3T MR imaging of the lumbar spine without intravenous contrast
FINDINGS:
Anatomy: Five lumbar-type vertebral bodies are present. The most inferior well-formed disc space will be referred to as L5-S1 for purposes of numbering in this report.
Prior surgical findings/hardware: None.
Vertebral bodies: Normal in height. Retrolisthesis at L2-3 and grade 1 anterolisthesis at L4-5. Mild left convex curvature of the lumbar spine.
Bone marrow: Normal for age. Small hemangiomas in L4 and L5. Mild fibrovascular and fibrofatty end plate changes at L2-3 and L4-5.
Intervertebral discs: Multilevel disc desiccation worse at L1-2, L2-3 and L4-5..
Conus medullaris: Normal. Positioned at: L1. Mild redundancy of the cord of fibrous at the lumbosacral region
Paraspinal muscles: No evidence of denervation or inflammation.
The following axial levels are detailed below:
T12-L1: Unremarkable.
L1-L2: Mild broad-based disc bulge with mild narrowing of the spinal canal. There is also mild bilateral neuroforaminal narrowing.
Exam(s):
MR LUMBAR SPINE WITHOUT CONTRAST
Exam Status:
Final
L2-L3: Small annular tear. Small disc extrusion. Moderate spinal canal and bilateral neural foraminal narrowing.
L3-L4: Mild broad-based disc bulge, no significant spinal canal and mild bilateral neuroforaminal narrowing. Mild facet arthropathy.
L4-L5: Annular tear and moderate extrusion. Severe spinal canal and moderate bilateral neuroforaminal narrowing left more than right. Severe facet arthropathy.
L5-S1: Broad-based disc bulge. Moderate left neuroforaminal narrowing. Mild spinal canal narrowing. Severe left facet arthropathy right.
Visualized sacrum and bony pelvis: Mild degenerative changes of the SI joints.
IMPRESSION:
Multilevel moderate to severe degenerative changes of the lumbar spine, most pronounced at L4-5 where there is severe canal stenosis and moderate neural foraminal narrowing.
MRI:
==================================================
MR LUMBAR SPINE WITHOUT CONTRAST: 10/12/2023 9:44 AM
INDICATION (as provided by referring clinician): Low back and leg pain, 6 weeks or more
TECHNIQUE: 3T MR imaging of the lumbar spine without intravenous contrast
FINDINGS:
Anatomy: Five lumbar-type vertebral bodies are present. The most inferior well-formed disc space will be referred to as L5-S1 for purposes of numbering in this report.
Prior surgical findings/hardware: None.
Vertebral bodies: Normal in height. Retrolisthesis at L2-3 and grade 1 anterolisthesis at L4-5. Mild left convex curvature of the lumbar spine.
Bone marrow: Normal for age. Small hemangiomas in L4 and L5. Mild fibrovascular and fibrofatty end plate changes at L2-3 and L4-5.
Intervertebral discs: Multilevel disc desiccation worse at L1-2, L2-3 and L4-5..
Conus medullaris: Normal. Positioned at: L1. Mild redundancy of the cord of fibrous at the lumbosacral region
Paraspinal muscles: No evidence of denervation or inflammation.
The following axial levels are detailed below:
T12-L1: Unremarkable.
L1-L2: Mild broad-based disc bulge with mild narrowing of the spinal canal. There is also mild bilateral neuroforaminal narrowing.
Exam(s):
MR LUMBAR SPINE WITHOUT CONTRAST
Exam Status:
Final
L2-L3: Small annular tear. Small disc extrusion. Moderate spinal canal and bilateral neural foraminal narrowing.
L3-L4: Mild broad-based disc bulge, no significant spinal canal and mild bilateral neuroforaminal narrowing. Mild facet arthropathy.
L4-L5: Annular tear and moderate extrusion. Severe spinal canal and moderate bilateral neuroforaminal narrowing left more than right. Severe facet arthropathy.
L5-S1: Broad-based disc bulge. Moderate left neuroforaminal narrowing. Mild spinal canal narrowing. Severe left facet arthropathy right.
Visualized sacrum and bony pelvis: Mild degenerative changes of the SI joints.
IMPRESSION:
Multilevel moderate to severe degenerative changes of the lumbar spine, most pronounced at L4-5 where there is severe canal stenosis and moderate neural foraminal narrowing.
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
醫生是建議physical therapy 還是surgery?
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
MRI的结论简单点说就是L4-L5有cord compression, L4-L5是骨盆上的那2段。至于为啥有cord compression,可能是年轻是受过伤(比如干重体力活,比如生小孩),也可能是肿瘤造成的。进一步预约的目的是发现原因和确定治疗方案。
美国现在这个MRI和PET-CT实在太离谱了,我们这里MRI预约都要半年以上,PET-CT 3个月。还有 surgeon, initial consultation 都要等半年,除非是做隆胸的,那是随到随做。。。当然,MRI快的也有,比如你是in patient,当天就能做。如果你大喊医生我cash,连waiting room都不用坐。总之,帝国余辉啊。
美国现在这个MRI和PET-CT实在太离谱了,我们这里MRI预约都要半年以上,PET-CT 3个月。还有 surgeon, initial consultation 都要等半年,除非是做隆胸的,那是随到随做。。。当然,MRI快的也有,比如你是in patient,当天就能做。如果你大喊医生我cash,连waiting room都不用坐。总之,帝国余辉啊。
qianlao 写了: ↑2023年 10月 15日 12:59 好不容易做了MRI,又要等3个月,才有下一个appointment。请感兴趣的大侠看看提提建议。多谢了。
MRI:
==================================================
MR LUMBAR SPINE WITHOUT CONTRAST: 10/12/2023 9:44 AM
INDICATION (as provided by referring clinician): Low back and leg pain, 6 weeks or more
TECHNIQUE: 3T MR imaging of the lumbar spine without intravenous contrast
FINDINGS:
Anatomy: Five lumbar-type vertebral bodies are present. The most inferior well-formed disc space will be referred to as L5-S1 for purposes of numbering in this report.
Prior surgical findings/hardware: None.
Vertebral bodies: Normal in height. Retrolisthesis at L2-3 and grade 1 anterolisthesis at L4-5. Mild left convex curvature of the lumbar spine.
Bone marrow: Normal for age. Small hemangiomas in L4 and L5. Mild fibrovascular and fibrofatty end plate changes at L2-3 and L4-5.
Intervertebral discs: Multilevel disc desiccation worse at L1-2, L2-3 and L4-5..
Conus medullaris: Normal. Positioned at: L1. Mild redundancy of the cord of fibrous at the lumbosacral region
Paraspinal muscles: No evidence of denervation or inflammation.
The following axial levels are detailed below:
T12-L1: Unremarkable.
L1-L2: Mild broad-based disc bulge with mild narrowing of the spinal canal. There is also mild bilateral neuroforaminal narrowing.
Exam(s):
MR LUMBAR SPINE WITHOUT CONTRAST
Exam Status:
Final
L2-L3: Small annular tear. Small disc extrusion. Moderate spinal canal and bilateral neural foraminal narrowing.
L3-L4: Mild broad-based disc bulge, no significant spinal canal and mild bilateral neuroforaminal narrowing. Mild facet arthropathy.
L4-L5: Annular tear and moderate extrusion. Severe spinal canal and moderate bilateral neuroforaminal narrowing left more than right. Severe facet arthropathy.
L5-S1: Broad-based disc bulge. Moderate left neuroforaminal narrowing. Mild spinal canal narrowing. Severe left facet arthropathy right.
Visualized sacrum and bony pelvis: Mild degenerative changes of the SI joints.
IMPRESSION:
Multilevel moderate to severe degenerative changes of the lumbar spine, most pronounced at L4-5 where there is severe canal stenosis and moderate neural foraminal narrowing.
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- 正式会员
- 帖子: 26
- 注册时间: 2023年 4月 20日 16:24
- 昵称(选填): qianlao
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- 正式会员
- 帖子: 26
- 注册时间: 2023年 4月 20日 16:24
- 昵称(选填): qianlao
Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
谢谢你,三个月后看能不能得到评估。littlek 写了: ↑2023年 10月 16日 03:54 MRI的结论简单点说就是L4-L5有cord compression, L4-L5是骨盆上的那2段。至于为啥有cord compression,可能是年轻是受过伤(比如干重体力活,比如生小孩),也可能是肿瘤造成的。进一步预约的目的是发现原因和确定治疗方案。
美国现在这个MRI和PET-CT实在太离谱了,我们这里MRI预约都要半年以上,PET-CT 3个月。还有 surgeon, initial consultation 都要等半年,除非是做隆胸的,那是随到随做。。。当然,MRI快的也有,比如你是in patient,当天就能做。如果你大喊医生我cash,连waiting room都不用坐。总之,帝国余辉啊。
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- 帖子: 7170
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
多约几个点,不同的地方等待时间差异很大。littlek 写了: ↑2023年 10月 16日 03:54 MRI的结论简单点说就是L4-L5有cord compression, L4-L5是骨盆上的那2段。至于为啥有cord compression,可能是年轻是受过伤(比如干重体力活,比如生小孩),也可能是肿瘤造成的。进一步预约的目的是发现原因和确定治疗方案。
美国现在这个MRI和PET-CT实在太离谱了,我们这里MRI预约都要半年以上,PET-CT 3个月。还有 surgeon, initial consultation 都要等半年,除非是做隆胸的,那是随到随做。。。当然,MRI快的也有,比如你是in patient,当天就能做。如果你大喊医生我cash,连waiting room都不用坐。总之,帝国余辉啊。
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
你得去和你的primary 不停的去哭诉,痛啊,睡不着啊,没法生活啊,
才可以推进的快一点,因为医生被保险公司牵制,必须按部就班走流程
你的情况如果是第一次急性发作,很大概率两三个月内可以自然恢复到不错,那么保险延缓推迟你的各项检查可以省掉一大笔费用,这也是为啥总是让费用最低的PT介入,就是指望你不治而愈或者以最低成本自愈。
但手术一定要慎重,如果你到骨科医生那里去评估,显然他们推荐手术的概率很高,说的好听点是他们是个锤子,看见的都是钉子,小人之心一点就是利益相关,开一个刀赚一笔。
所以一是耐心,相信人的身体有很强的自愈能力,二是应该继续试试好的PT。
另外如果是资源的问题,考虑扩大搜索医生的范围,周边300miles以内都可以看看,你只是要诊断,不是手术,应该可以找到还不错的。
Primary 家庭医生其实挺重要的,他们知道谁好谁坏,有connection的甚至可以帮你到专科医生那里插队。
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
谢谢大虾们的指教。我的理疗其实就是网上常见的一些动作,没有什么效果。
针灸也做了4次了,据说要几个月。
针灸也做了4次了,据说要几个月。
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
还是先要有诊断结果,排除肿瘤等可能(但MRI照理说能看出肿瘤的),
不然任何的治疗方案都是盲人摸象,
不停的去骚扰家庭医生和保险公司,要求早点约专科,
而且你现在就要去调研专科医生,美国医疗资源紧缺,好的专科医生约到半年一年以后也很常见,取决于你那里的医疗资源。
也可以要求PT和家庭医生去说,认为PT没有任何效果,病人很痛苦,无法开展手法等等,加速等待过程。
如果你只是小关节紊乱,错位的话,国内中医手法复位治疗是非常有效的,好的医生一次治疗可能就消除大部分症状。
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- 正式会员
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Re: 请教-腰背,臀,小腿,脚,坐骨神经痛,针刺麻
谢谢MRMAJA指教。迄今确实都是在摸象。