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Suggest Treatment For Osteoporosis

Posted on Sat, 11 Oct 2014

Question: I was in contact with you before. I was wondering if you could review my scans and let me know your views. Thanks.. scans are attached to my profile

Answered by Dr. Eris Ranxha (10 hours later)

Brief Answer:
No spinal stenosis

Detailed Answer:
Dear
Thanks for sharing with HCM your concern

I carefully observed your MR report
Dear it has no evidence of spinal stenosis
No big discal herniation were seen
You have several destruction on vertebral borders which is a relative sign of osteoporosis
So it is reccomended that you schedule a DEXA scan which is an examination that measures the bone density
If the examination will confirm osteoporosis than you should consult your rheumatologist and start treatment
In the meantime use ibuprofen and lumbar fortress to avoid fracture

Hope my answer will help you to the right diagnose and treatment
Best Regards
Dr Eris Ranxha
Neurologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Eris Ranxha (23 minutes later)

I .. d id you look at my neck scan..and brain scan.. are these ok.. I would appreciate if you could review these and see if I would benefit from a neurologist opinion.
Thanks
XXXX

Answered by Dr. Eris Ranxha (28 minutes later)

Brief Answer:
No brain images

Detailed Answer:
Dear,
I don't see any brain images in your report
And sagital reports on spine are just thoracic and lumbar
Anyway I don't see any thing going wrong on axial view of cervical spine
As a conclusion dear you aren't suffering from something which need surgery immediately
In my opinion schedule test I suggested and start treatment after test result
Reschedule spine MRI after 6 months to see the progress
Avoid physical stress and use NSAIDs or myorelaxants as pain killers and wear a lumbar fortress
Wish you all the best
Regards

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Eris Ranxha (18 minutes later)

is there a bulge on the cervical scan.. do you think it is worth my while seeing a neurologist.. I am already with a very good spine surgeon.. he got me to do a brain scan which was perfect.. I do not want to waste money seeing a neurologist if there is no need to see one..i do get pins and needles in feet and hands..as a result of the disc.. I think.thnsk

Answered by Dr. Eris Ranxha (2 hours later)

Brief Answer:
Not surgery

Detailed Answer:
Dear
The symptoms you described could be from cervical prolabiation (first stage of disc herniation)
In my opinion it will be better for you to wear a soft cervical collar and schedule a spine MR after 6 months
The actual MR doesn't show mielomalaci which needs surgery
Avoid physical stress wear cervical collar(max 4 hours a day) and wait
If you have pain or those pins and needles bothers too much you can start treatment and they can be managed (pregabalin)
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Eris Ranxha (5 hours later)

than.ks.dkso you think that I should see a neurologist.. my doctor does not see the need.. my spine surgeon is very good...he is very knowledgeable..and has done a brain scan.. there was no pathology..my surgeon does not seem to think the neck is serious at all.. also I was about to have micro surgery for the back recently..it was postponed. the l4l5 disc herniated and I had right leg unilateral sciatia.. for some reason it healed itself.. I assume you would say avoid surgery thanks

Answered by Dr. Eris Ranxha (7 hours later)

Brief Answer:
Avoid surgery

Detailed Answer:
Dear
Surgery is the last step the patient should take when there are no other treatment possibilities
Avoid surgery
Stay healthy
Best regards
Dr Eris

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Eris Ranxha (6 hours later)

I asked you before.. do you think I need to see a neurologist..or is it a waste.. my brain scan was fine and my spine surgeon never recommended one.. thanks

Answered by Dr. Eris Ranxha (1 hour later)

Brief Answer:
yes, you need to see a neurologist

Detailed Answer:
Dear
the imageric status you have needs a neurological examination and probably treatment if symptoms will bother you
in my opinion you should consult a neurologist and decide for surgery when your neurologist will recommend it
Hope my answer clarify your doubts
Best regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Eris Ranxha (6 hours later)

would a neurosurgeon be ok? I get assessed regularily from my physio and my consultant has tested me also

Answered by Dr. Eris Ranxha (1 hour later)

Brief Answer:
I think is the same

Detailed Answer:
Dear
if the neurosurgeon has the capacity to do the neurological exam i think it will be ok.
In my opinion if you can schedule a neurologic consult in the future, you should do so because sometimes surgeons are prior to surgery.
Anyway as i told you earlier you have nothing to worry too much
Those are all minor problems
Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Eris Ranxha (3 hours later)

if my neck bulge herniates.. is this dangerous.. do they normally get better by themselves.. did you see a neck bulge on my scan or is it bone? also i have no major neurological signs only pins and needles in hands and feet.. surely this is not enough to operate on..? is it safe to walk and swim with my condition..i avoid physical work..is the l4l5 disc a bulge or a herniation?by the way i did have a bone scan done and there is ostheophenia..i am on calcium tablets.. i had a blood test done also and there is no rhuematism..i am glad you said to avoid surgery.. i nearly had a microdiscemony last week and my sciatic pain disappeared by itself.. thtis is why i am asking you about the neck disc issue... i absolutely do not want this surgery in the neck..one of your other people in healthmagic mentioned surgery..i was so upset. i guess different doctors have different opinions of scans

i meant to ask.. are you saying there is no damage to the spinal cord at the moment in the neck.. also are the lower disc problems l4l5 l5s1 related to the spinal cord at all.. would a microdis. solve any problems.. thanks

Answered by Dr. Eris Ranxha (5 hours later)

Brief Answer:
Infiltration

Detailed Answer:
Dear
I told you earlier that way off treating small destination are avoiding physical stress and protect them by wearing cervical collar or lumbar fortress
Swimiming is perfect it is the only physiotherapy
Walk but avoid long walks and running
In my opinion I would suggest infiltration a cortisone injection on your germination which will relief your pain
Regards

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju