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Old 11-06-2007, 08:36 AM   #1
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ilakshmir HB User
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/*****ly 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.


MRI report:

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
encroachment.

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.

Conclusion
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.

 
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Old 11-06-2007, 09:38 AM   #2
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tmarkfer HB User
Re: Please help me understand my MRI Report

What type of surgery does he want you to have? I tryed my chiroprac and I felt worst after. The epidurals may help you. I would try that. becareful when you have a chirprator work on your back. Did he see your MRI report? I had my L5-S1 fused last year. That seems to be healing but I am having problems with my nerves at the L5-S1. I also have numbness and tingling/*****ly in my legs and my new surgen says it is from the nerves being crushed. I know this may not be much help but it is worth a try.

Last edited by HBMod07; 11-10-2007 at 10:37 AM. Reason: Please only quote the portion of the message you are responding to and not the entire message.

 
Old 11-06-2007, 12:06 PM   #3
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ilakshmir HB User
Re: Please help me understand my MRI Report

Hi tmarkfer

Thanks for your response. My doc has suggested fusion of L3-L4-L5. I am very worried abt going into surgery. I would like to try every possible alternate therapy before that.

 
Old 11-08-2007, 06:44 AM   #4
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Location: NJ
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tmarkfer HB User
Re: Please help me understand my MRI Report

I agree with trying every possible alternative first. My fusion was my first surgery that I ever had. The only time I was in the hospital was to have my daughter. We will all help you get through this. But I will tell you this don't wait to long and let your back get worst. I am happy that I had my fusion now only if we can fix the rest. Just to let you know, My nerve problem is from my back being streched out for so long it had nothing to do with the fusion.

Last edited by HBMod07; 11-10-2007 at 10:38 AM.

 
Old 11-09-2007, 01:47 AM   #5
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iliananj HB User
Re: Please help me understand my MRI Report

wow, I'm 30 as well, similar probs l4-5 s1 disc herniation with bilateral radiculopathy, nerve pain in both legs. try all forms of conservative treatments, surgery was my last option when epidurals weren't helping and I was on a full medical leave, barely walking. I had a discectomy may 2005 where they remove the herniated portion of the disc to relieve pressure from the nerves that is causing the leg pain. 12 days post surgery, I suffered a complete disc collapse, they say because removing portions of the disc can make it unstable. there is practically no space left, and it feels like it grinding bone on bone. I now have to consider more sugery to correct. a bilateral laminectomy, with fusion, placements of pedicle screws and something called a dynamic stabilization.

I'm now on disabilty, in chronic pain. the leg pain, numbness, heaviness, tingling, burning, freezing, and buzzing sensations drive me crazy. my legs have also become hypersensitive. I can relate to you. don't get discouraged, if you're going to have to have surgery, make sure you get at least 5 or more opinions, and then some. because some docs will only peddle certain kinds a therapies or surgeries because that is what they specialize in. I panic every time I consider this surgery I have to have. I swear my docs and therapist are conspiring by them all telling me that it's a "minimally invasive procedure" to try to allay my fears. but my first procedure was minimally invasive as well, my disc collapsed, and actually re-herniated. so I have to a bigger procedure now.
I don't care how often they say minimally invasive= less cutting they say, it's still my spine. surgery is surgery. make sure you inform yourself. I only had the surgery when nothing else worked and the leg pain just getting worse. surgery was my last option. I wish you luck...they say don't knock it til' you try it...what therapy worked for someone might not work for you...I did the entire gamet of conservative treatment, except for trying accupunture (can't get over the needles but some people have had relief with that. there's this new thing call DRX5000, which is like getting traction, some swear by it. hang in there ok

Last edited by moderator2; 11-09-2007 at 05:11 AM. Reason: posted commercial website

 
Old 11-09-2007, 03:54 AM   #6
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yvette777 HB User
Re: Please help me understand my MRI Report

I would try to research those things and try therapists approach's and pain management approaches but not chirorpactic. Talk to a neurosurgeon and get there opinion. Or a spine specialist.

 
Old 11-09-2007, 04:38 PM   #7
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ilakshmir HB User
Re: Please help me understand my MRI Report

Thanks all for your responses. After making some enquiries I have started seeing a chiropractic. I had 4 sittings on a Vax-D machine. So far I have not seen any negative reactions. Yet to see definitively positive ones. With the treatment , at times for a few hours it feels like the *****ly sensation/numbness has disappeared. Sometimes they reappear and I wonder if it is helping me at all.

One thing he said is the pressing of the nerve is due to inflammation and muscle spasm and not necessarily from the disc pressing the nerve. He thinks I should be get better as the imflammation and spasm come down. I have been advised omega-3 fish oil, Boswella extract and at least 4 liters of water to rehydrate the disc. I have about 28 more sittings to go.

Will let you all know how this progresses.

 
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