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Interview with Spine Surgeon april 26,2007

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Interview on April 26th concerning grossly pinched nerve.

1. Severe central canal stenosis @ L4-5, moderate @ L3-4 and mild @ L2-3

2. Degenerative arthritis @ lower 3 lumbar levels; Grade 1 spondylosistheses; 6mm cyst @L4-5 & L5-S1.

3. Broad-basd partial disc ext. @L4-5 w/superior ext, mld posterior spondylic changesof bulges at remaining lumbar levels.

4. Moderate to marked bilateral neutral formamial narrowing a

@ L4-5 with likely nerve root abutement. (there maybe mistakes in DX as am pateint, not medical)


MRI Lumbar Spine w/o contrast on 01/04/07. DX with Essential Tremours in 1995. Slight jitters in right hand since age 40 : Postural. Major face first fall on concrete 12/24/04, moderate head concussiom, hair-line fracture on left upper part of shoulder and clean break of Ulna from Olecronon with 2 pins and butterfly holding in place permanently. First consistant tremour started about 3 months after break and only in right hand. Became progressively worse and by June 2005. DX by Neurologist as early stage adult Parkinsons Perhaps stage 2.


With this pinched nerve problem and my delayed reactions to sedatives and general anesthetic, "What pre-meds should I be given and would it be better for me to have spinal epidural morphine pump as compared to local or general or sedative with this problem I have with medication Versed and one for pain since having a delay period of 15 to20 minutes?" Recent colonoscopy meds given did not go into effect until 10 minutes after procedure, then did not remember anything after the procedure. This delay problem recent but seems to have bgun about the time DX with PD.

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If you are at all worried about your thinking get a baseline neurocognitive profile from a neuropsychologist before surgery.


In PD anaesthesia, the surgery, pain meds, and the PD itself can make symptoms worse.


We generally recommend as light of anaesthesia as possible, and to take it easy during post-op and have your neurologist ready to change meds if possible. Confusion is common post-op and you should be ready to treat and be patient.


Good luck.

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Thank you for a very interesting reply, Dr Okun,


Your answer has given me more things to think about and to discuss with spine surgeon so he understands about the anesthetic and PD fear I have, especially with this new wrinkle of my body chemestry to it. Cannot beleive a few drops of Novacaine to deaden area in back for an steiod epidural injection could make me loopy after the procedure over with, but not work when given to releive pain. My reactin to the novicaine was like some thing only experiened with calming drug one gets in IV before major surgery. And not remembering how I got home is scarey cause took a taxi. (live aone)


Will cetainly show this surgeon your suggestion.



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