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Old 05-28-2012, 05:35 AM   #1
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Sciatica, low back and down the left leg and foot pain with numbness in left calf

This is what my MRI shows, what do they usually start with trying to fix my pain? Such as shots, pain meds, surgery or what? I can't just take any kind of medicine because I am on several medicines after having a heart attack last year with a stent and still have palpitations and angina. I'm still waiting to get back into my regular md to see what he says.

Findings:

There is normal alignment of the lumbar spine. Vertebral body heights are well-maintained. There is
mild intervertebral disc space narrowing of the lumbar spine most pronounced at L3-4 and L5-S1 with
mild disc desiccation and endplate osteophyte formation. There is a vestigial disk at the S1-2 level.
There is no marrow edema. There are no fractures. No destructive lesions are identified.

The paravertebral soft tissues are unremarkable. Conus medullaris terminates at the L1-2 level.

Findings by level:

L1-2, L2-3: There is no significant central canal, lateral recess nor neural foraminal narrowing.

L3-4: There is minimal generalized disc bulge with endplate osteophyte formation at this level. There
is minimal facet arthropathy as well. There is resultant mild central canal, lateral recess and neural
foraminal narrowing without transiting nor exiting nerve contact.

L4-5: There is minimal active facet arthropathy at this level without significant central canal or lateral
recess neural foraminal narrowing.

L5-S1: There is minimal broad-based posterior disc bulge with a right central to foraminal
high-intensity zone best depicted on sagittal images 10 and 11. There is mild facet arthropathy at this
level. There is minimal central canal, lateral recess and neural foraminal narrowing without transiting
nor exiting nerve contact.

Impression:

1. Mild multifactorial degenerative change of the lower lumbar spine without transiting nor exiting
nerve contact noted at any level.
2. High-intensity zone within the right central to foraminal posterior margin of the disc at the L5-S1
level.

 
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Old 05-28-2012, 06:42 AM   #2
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Re: Sciatica, low back and down the left leg and foot pain with numbness in left calf

Keep in mind that the results of a MRI are just one piece of the diagnostic puzzle. Your doctor will use the results of this, as well as a physical and basic neurologic exam and what you tell him of your symptoms to arrive at a diagnosis. I can give you an idea of what some of the language means so you'll better understand what your doctor is describing to you when you see him.

Without the title of your post to give me a little information, I would conclude that you had some minor degenerative changes going on throughout your lumbar spine, but nothing that would indicate you were having issues of pain.

As you can see from the report there are a couple of small things going on from L3 on down that are an indication of early degenerative changes: minimal disc bulge, minimal facet arthropathy (which means there is a bit of arthritis in the facet joint).

The odd thing is that I don't notice anything that would cause the pain on your left side. At L5-S1 there is a disc bulge that is pushing out on the right side.

[B]L5-S1: There is minimal broad-based posterior disc bulge with a right central to foraminal high-intensity zone best depicted on sagittal images 10 and 11. There is mild facet arthropathy at this level. There is minimal central canal, lateral recess and neural foraminal narrowing without transiting
nor exiting nerve contact. [/B]

Usually when someone has pain that radiates down a leg, it is due to a spinal nerve compression. There are several locations where this can happen. One is the central canal which is the main nerve center in the body, where nerves carry signals of sensation and motion back and forth to the brain. Compression here is usually from a large disc bulge that pushes into the side of the central canal.

A second location is in the neuro-foramen. At each vertebral segment, there is a foraminal opening on each side that allows the spinal nerves to pass out of the spine into the body. If this "opening" becomes clogged, there is less room for the nerve. It can result in the nerve getting constricted or pinched due to lack of space. But as you can see, your report indicates there isn't anything going on that is making contact with the nerves at this level.

And yet we know from your reporting of symptoms that you have pain and numbness in your left leg, so, what is causing it? Your bulge is pushing out to the right side. It may be that the "high intensity zone" that is mentioned is responsible for your pain. This is what is also referred to as an annular tear, and it can be painful.

Conservative treatments will be tried first. This usually consists of a course of physical therapy, oral medications and sometimes injections of a steroid.

Please come back and let us know what you find out from your doctor and what type of treatment he/she recommends.

Last edited by teteri66; 05-28-2012 at 06:44 AM.

 
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