Case presentation: A 50-year-old female presented to the office with complaints of severe low back pain radiating down the leg. She had been dealing with this pain for a few months now. Increase in activity and walking increased her pain. She tried medication and injections with little relief of pain. She had difficulty ambulating due to the pain. Review of her MRI showed a large synovial cyst at L4-5 causing severe stenosis, a posterior disc bulge causing stenosis, and spondylolisthesis at L4-5.
She underwent a left minimally invasive L4-5 synovial cyst removal, hemilaminectomy, medial facetectomy, foraminotomy, and discectomy with subsequent interbody placement and fusion with pedicle screws bilaterally at L4 and L5. The fusion was done to help stabilize the spine.
Postoperatively the patient did very well. At her follow up visit she stated she was pain free. She was ambulating well on her own. All of her symptoms prior to surgery were no longer present.
Image 1 shows stenosis of the thecal sac.
Images 2 and 3 show the synovial cyst attributing to her symptoms.
A 52-year-old female presented to the office with severe low back pain with radiculopathy to the right leg. She described the pain as sharp, shooting, and shock-like. She was unable to walk due to the pain. She had been given pain medications and intramuscular injections with no relief of symptoms. She underwent an MRI which showed a synovial cyst at right L4-5, which can be seen in Image 2. She also had a CT myelogram which showed a filling defect (decrease in contrast dye flow) at right L4-5, as seen in Image 1.
The patient underwent a right L4-5 MIS synovial cyst removal. This procedure is done by making a small incision on the lower back, inserting a small tube, and removing bone. After the bone was removed, we were able to visualize the cyst and remove it, relieving pressure off the nerve root/thecal sac.
Post-operatively, the patient did very well. Her pain level decreased dramatically and she was able to walk on her on. She has returned to work as well.
Happy Halloween from our staff to you!
Our Team is looking for an individual who is a motivated team player. Medical experience preferred. Organizational skills are a must. The ability to work at a fast pace is also required. Part-time position available.
ILYAS MUNSHI, MD
Part Time Medical Assistant
Ugly Christmas sweater picture
Are you scheduled for lower back surgery? Here is a website with helpful tips to help you prepare and recover: https://reptn.io/AkdzBvAdJAs
Did you know today was National Pharmacist Day? Don't forget to take time to thank them today. Give them a shout out. Whether they work in a facility or local pharmacy, they will appreciate the good word.
#NationalPharmacistDay
Smoking can have many negative effects on your body. Smokers are more prone to back pain than nonsmokers because nicotine restricts the flow of blood to the discs that cushion your vertebrae and increases the rate of degenerative change. Smokers also have double the risk of an osteoporotic fracture than nonsmokers because cigarette smoking reduces calcium absorption and prevents new bone growth. If you are a smoker, quitting smoking can benefit your health in many different ways and will reduce your risk of future back pain.
February is the start of American Heart Month.
The heart is responsible for sustaining all of the other organs in the body, so it must be kept in good health. People get consumed by the stressors of everyday life, and they rarely stop to consider whether or not their hearts are in good condition. The lack of attention paid to one of the most important organs of the body can lead to heart disease or other health problems.
What is spinal stenosis?
That's easy to explain. Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on the nerves. Most often, spinal stenosis occurs in the neck and the back. While some people with spinal stenosis may not have symptoms, others may experience pain, tingling, numbness, and muscle weakness.
What are the symptoms of spinal stenosis?
*Back Pain
*Neck Pain
*Numbness or tingling in a hand, arm, foot or leg
*Weakness in a hand, arm, foot or leg
*Problems with walking and balance
*Pain or cramping in one or both legs when you stand for long periods of time or when you walk, which usually eases when you bend forward or sit
If you are experiencing any of these symptoms, give us a call to set up an appointment and let us help.
Ilyas Munshi, MD
January 28 at 3:00 PM ·
This week’s case presentation is a 41-year-old female with a pituitary adenoma. The patient has a history of seizures and headaches. She had an MRI done which revealed a 1.8cm pituitary lesion (Image1). She had lab work to evaluate pituitary function and no abnormalities were found.
She underwent a transsphenoidal hypophysectomy for biopsy/removal of lesion. This procedure involves the neurosurgeon as well as an otolaryngologist (ENT). The ENT goes in through the nose and exposes the pituitary fossa. Once this is done, the neurosurgeon will then open the dura, the covering of the pituitary. After the dura is open, the tumor is removed.
In this case, as we began to remove the tumor, a white creamy like material came out (Image 2). Cultures were taken and samples were sent to pathology. The final pathology report showed a pituitary adenoma.
A pituitary adenoma is benign (non-cancerous) tumor that grows on the pituitary gland. Pituitary adenomas make up about 10-15% of all tumors developed in the skull. These tumors are named based on their size; tumors larger than 1cm are called macroadenomas and those less than 1cm are called microadenomas. The exact cause is unknown. Some symptoms include headaches, vision changes, weight loss or gain, and fatigue. If the tumor becomes very large and puts pressure on the pituitary it can cause a decrease in function of the pituitary gland.
There were no complications from the surgery and the patient did well post-operatively. She is being followed with repeat imaging which has remained stable.
Happy Mardi Gras, Yall!
Our office is closed Monday and Tuesday. We will reopen Wednesday morning at 8:00 am. Stay safe everyone!
Ilyas Munshi, MD
March is the start of National Traumatic Brain Injury Awareness Month. Traumatic brain injuries are caused by an impact or force to the head or body or a penetrating injury to the head, affect millions of U.S. persons each year.
Our Team is looking for an individual who is a motivated team player. Medical experience preferred. Organizational skills are a must. The ability to work at a fast pace is also required.
Full-time position is available in the future.
ILYAS MUNSHI, MD
Medical Assistant
Our Team is looking for an individual who is a motivated team player. Medical experience preferred. Organizational skills are a must. The ability to work at a fast pace is also required.
Full-time position is available in the future.
ILYAS MUNSHI, MD
Medical Assistant
March 15, 2021, to March 21, 2021, is Brain Awareness Week!
The Dana Foundation is doing great work to foster enthusiasm and support for brain science. reptn.co/AgwvkdB-AdA
BRAINAWARENESS.ORG
Brain Awareness Week | Dana Foundation
