23 Dec Success Story of the Month | December 2019
I have seen countless patients over the years, and I am generally not prone to praise myself. There have been many patients who have gotten permanent months of improvement and several who have gotten longstanding improvement secondary to a decrease in their discomfort, thus allowing them to build up the core muscles and heal. However, these types of patients I find commonplace, and although I do rejoice in their improvement, that is not so unusual.
There was a patient who came to my office, referred strictly for lower back pain and other joint discomforts. On physical examination, I could not attribute all her back pain to the joint. She had a history of hypertension, and no mass was detectable in her abdomen. As a lot of her back pain was exacerbated by back extension, I felt that a lot of the pain could be facet arthritis. I ordered an MRI of the lumbar spine to rule out spondylolisthesis, which is slippage of the vertebral body, and spinal stenosis, which is narrowing of the spinal canal. I generally like to rule out things rather than subject a patient to a procedure unless there is a high degree of certainty it would give him or her benefit. I had plans to do either lumbar facet injections or, if necessary, a rhizotomy. After reviewing the MRI, the lumbar spine showed some facet arthritis and other two diagnoses that were not present. However, there were aneurysms in her renal artery that were quite advanced in size. I notified her primary physician, who then referred her to a vascular surgeon.
I was later informed that had I not seen the renal aneurysm, and if she did not have surgery, there was a high degree of chance she would not be alive. After that, she had healed from her renal artery surgery we did with lumbar facet injections, having significant improvement to her lower back pain.