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Old 09-29-2012, 06:13 PM   #1
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Understanding MRI report

Recent MRI report states: severe narrowing of spinal canal at L3/4 and L4/5 caused by disc bulges with narrowing of right L4 neural formen and left L/5 nerual foramen

Can anyone tell me if this could be the reason for the neuropathy in my feet. Have dr. appt in a week or so but thought maybe someone could help with the interpretation before.

Hoping this doesn't mean surgery. any ideas? thanks

 
Old 09-29-2012, 08:55 PM   #2
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Re: Understanding MRI report

Do you have numbness in both feet or what are your symptoms?

About six years before I developed spine issues, I was told by a podiatrist that the reason for the weird feelings in my toes was caused by peripheral neuropathy. I told that news to my internist, who dutifully recorded it in my permanent record.

It wasn't until seven years later that a pain management doctor asked me how my peripheral neuropathy was diagnosed, and I realized it was done on the basis of one guy's "diagnosis." Had an EMG and it turned out my problems were stemming from L5 and S1 radiculopathy.

Your radiology report indicates that you have severe stenosis. This is a narrowing of a passageway that contains the spinal nerves, either the central canal, or the little openings located at each spinal segment that allow the spinal nerves to pass out from the spine to the limbs and other areas of the body. It is a major reason for nerve pain that can be felt in the back or any place along the path of the nerve.

You can look online for a "dermatome map" which will show you which spinal nerves innervate which area of the body. The L3 nerve tends to innervate the front of the thigh, coming from the outside of the hip, then crossing over and innervating the inside of the calf, going down into the foot. L4 runs along side it going over the top of the foot and into the big toe, and L5 goes down the outer side of the leg, down the shin and across the top of the foot into the three middle toes.

Stenosis can be caused by several different issues, but yours is apparently caused by the discs at L3-L4 and L4-L5 that have herniated in such a way that they are taking up more space than just the disc area in between the two vertebrae. They are pushing into the central canal and right L4 neural formina and left L/5 nerual foramina.

Depending on the extent of the nerve compression, the doctor will want to try conservative measures such as a course of physical therapy, oral medications and perhaps a series of epidural steroid injections (ESI) to see if your pain can be resolved.

It is important that you find a fellowship-trained orthopedic spine surgeon or a neurosurgeon who limit their practice to the neck and back. to ensure you get an accurate diagnosis and plan for treatment. One can waste a lot of time letting a family doctor manage the case.

Good luck.

 
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