Please help me understand my MRI Report
I am 30 year old female who has had chronic back pain on and off for the last 5 years. Recently I started getting tingling/prickly sensations in both my legs. The MRI report is pasted below. My chiroprac has recommended spinal-decompression therapy across 25 sittings. He gives me 50% chance of improving. My Orthopaedic has suggested epidurals; if they dont work he wants me to try surgery. But there seem to be multiple risks with surgery as well. People, please help me understand what would be the best thing to do.
History : Low back pain with right lower extremity radiculopathy.
Comment : Multiplanar/multipulse sequence MRI of the lumbar spine is
presented for review. The lumbar vertebral bodies maintain normal
stature. There is partial straightening of the lumbar lordosis which
may be related to patient positioning, muscle spasm or even a chronic
finding. The conus medullaris terminates normally at the L1 level
presuming five lumbar-type vertebrae anatomically for this report.
Ther are mild multilevel facet degenerative changes. There is
degenerative disk signal loss at L3-4 and L4-5. The lumbar discs are
slightly small in stature anatomically.
At T12-L1,L1-2 and L2-3 the posterior disc contours are normal.
Central cancal caliber is normal at each of these levels and the exit
foramina are patent.
At L3-4 there is a moderate sized posterior disc protrusion
predominantly near the midline with annulus fissuring and with
findings suspiscious for superimposed subligamentous herniated nuclear
material, age-indeterminate. There is a ventral dural sac indentation
and upwards of moderate overall dural sac narrowing. The exit foramina
are relatively patent.
At L4-5 there us a more broad-based moderate sized posterior disc
protusion worse to the right of the midline than the left with
anmnulus fissuring/tear and findings consistent with age-indeterminate
herniated nuclear material (subligamentoius) near the midline/right
of midline. There is moderate central canal narrowing/dural sac
narrowing and right greater than left lateral recess encroachment.
Given the provided history clinical correlation to the right L5 nerve
root distribution is suggested. There is minimal bilateral foraminal
At L5-S1 the posterior disc contour is normal. Central canal caliber
is normal at this level, the exit foramina are patent. The S1 lateral
recesses are clear.
1. Discogenic degenerative changes and at least moderate-sized
posterior disc protrusions at L4-5 and to a slightly lesser extent
L3-4 (eccentric to the right ar L4-5 and near the midline at L3-4)
with annulus fissuring/tear at both levels. The overall appearance
suggests chronicity although there are findings suspicious for
subligamentous herniated nuclear material at both levels.
2. Moderate overall central canal/dural sac narrowing at L3-4 and L4-5
with ventral dural sac indentations at both levels . Right greater
than left lateral recess encroachment at L4-5 (clinical correlation to
the right L5 nerve root suggested).
3. Mild multilevels facet degenrative changes. Mild bilateral multilevel
l4-5 foraminal encroachment with remaining lumbar exit foramina patent.