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Old 10-21-2009, 02:08 PM   #1
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Red face MRI results of lumbar spine---what treatment options do I have

20-Oct-2009 14:51:00 Exam: MRI LUMBAR Sp NORM
Indications: mri lumbar spine- pain back lumbar,
ORIGINAL REPORT - 20-Oct-2009 21:08:00
MRI of the lumbar spine without contrast 10/20/2009. No prior studies available for comparison.

The most likely cause of a right-sided radiculopathy is a right paracentral disc extrusion at L5-S1. Multilevel degenerative changes will be described on a level by level basis:

L1-L2: Negative.

L2-L3: Broad-based disc bulge with annular fissure creates minimal bilateral neural foraminal narrowing.

L3-L4: A broad-based disc bulge demonstrates a small amount of central focality. This minimally indents the ventral aspect of the thecal sac. The disc bulge creates only minimal bilateral foraminal encroachment.

L4-L5: Prominent vertebral endplate changes with associated Schmorl nodes. Given that a large portion of these are fatty on T1-weighted images, these likely represent degenerative endplate changes that are converting from Modic type I the Modic type II. Given significant vertebral endplate fatty signal, discitis- osteomyelitis is considered less likely. Nevertheless correlation with symptoms and laboratory values is recommended. A broad-based disc bulge creates mild bilateral foraminal narrowing.

L5-S1: There is a prominent right paracentral disc extrusion with disc material compressing the transiting right S1 nerve root in the lateral recess behind S1. An associated broad-based disc bulge creates mild bilateral foraminal narrowing. Prominent degenerative endplate changes.

Moderate multilevel lumbar facet degenerative changes. A small 7 mm synovial cyst associated with the left L2-L4 facet joint does not create neural impingement. Otherwise, negative.

 
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Old 10-21-2009, 09:47 PM   #2
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Re: MRI results of lumbar spine---what treatment options do I have

I got my MRI results back on my Lumbar as well. Mine say this:

Degenerative height loss and signal lose at L2-3, L4-5 and L5-S!.

L3-4: A broad based circumferential disc buldge without focal protrusion or herniation is present.

L4-5: A small central disc protrusion with annular tear is present, flattening the thecal sac anteriorly. Mild degenerative facet joint changes noted.

L5-S1: A focal central disc protrusion with annular tear is present, flattening the thecal sac anteriorly, but not appearing to displace or impinge upon either right or left S1 nerve roots. Mild degenerative facet joint changes noted.

The paraspinal musculature is larely maintained and is symmetrivcal throughout.



Gettinold,

I think we have similar results. What symptoms are you having? Yours doidnt mention any annular tears but the wording was just different...

Can any shed more light on our results?

 
Old 10-24-2009, 07:51 PM   #3
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Re: MRI results of lumbar spine---what treatment options do I have

Treatment options go more by your symptoms, rather than the results of the tests because one person can have a bulging disc with no symptoms where the next person with the same result may have alot of pain. Would you please post your pain and symptoms, severity, type, burning, tingling, shooting, aching etc., and how often and then we may be able to help you. Thankyou

 
Old 10-24-2009, 11:02 PM   #4
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Re: MRI results of lumbar spine---what treatment options do I have

[QUOTE=Kasey443;4107746]Treatment options go more by your symptoms, rather than the results of the tests because one person can have a bulging disc with no symptoms where the next person with the same result may have alot of pain. Would you please post your pain and symptoms, severity, type, burning, tingling, shooting, aching etc., and how often and then we may be able to help you. Thankyou[/QUOTE]

Thanks Kelsey:

My symptoms include weak overall feeling. Sore muscles throughout butt area, expecially across top of pelvis and near the spine on the left side right under my PSIS. These pains are just achy. Ialso get this little popping/cracking down there, SI? Lumbar? I was told by my PT that I have a hypermobile, L5-S1.

 
Old 10-26-2009, 06:42 AM   #5
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Re: MRI results of lumbar spine---what treatment options do I have

On a pain scale of 0-10 (10 is worst pain), my pain has been anywhere from 2 to 10. It is shearing in nature from my right posterior iliac crest radiating through right buttock and then becomes crampy from right lateral thigh to calf and stabbing at right lateral ankle ending with numbness/tingling right lateral foot to second toe. Pain is worse in the morning and with certain activities such as going from sitting to standing position, getting in and out of a car, etc. I have been sleeping on the floor. Tried sleeping in a bed twice, but ended up feeling worse in the morning. I am taking Ultram, 1-2 tablets q4hrs, Prednisone, 20mg bid, and alternating Tylenol and ibuprofen. I have also been alternating ice and heat for comfort. I was taking flexeril 10 mg tid but no longer as I am out. I have a spine center appt on 10/30.

 
Old 10-26-2009, 09:10 AM   #6
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Re: MRI results of lumbar spine---what treatment options do I have

In a nutshell, the nerves exiting the spinal column between L3 & L4 are giving you the pains down the buttocks and back of leg. Nerves between L4 & L5 are creating the pain down the fronts of the legs and into the foot. Had all the same issues. DON"T PUT OFF SURGERY! Just make sure you do your homeowrk on your surgeon. Check him or her out thoroughly. Had L4-L5-S1 fusion 5 years ago. Wasn't a good job and made them redo 6 months later. By then the left forward half of my right foot feels tingly and numb most of the time, and throbs like mad when I take shoes off at the end of the day. The nerves were damaged beyond regeneration. Pain acted up again a year or so ago but this time down the buttocks and back of the legs. Ended up with another surgery where they removed the previous and added L3-L4 to the fusion. The lightning bolt type leg pains are gone but my back gets very stiff. I am 6 months out of surgery, and other than the stiffness in the mornings and with certain activity, the back is "pain" free. Good Luck

 
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