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  • Can I be helped with Surgery in this case? L5

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    Old 04-04-2015, 07:08 AM   #1
    Comandante
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    Question Can I be helped with Surgery in this case? L5

    I injured my back in a parachute jump in 1996, I am now 48 y/o and still in pain on and off so I am considering if surgery will help me. Please someone look at my latest MRI result and shine some light (opinions, suggestions) into which direction I should take.

    I guess my questions are:
    A) Even thought I can manage the pain, and I am provided with 800mg 3 x day of Ibuprofen, should I consider surgery?
    B) Is there surgery for what I have?
    C) If I don't do surgery, will the issue increase as I grow older and after my window for surgery closes?
    D) Would you have the surgery done by the VA hospital since it is the only option I have?
    E) Is Ibuprofen addictive or does it the body develop a tolerance?


    MRI LUMBAR SPINE WO CONTRAST (MRI Detailed)

    Reason for Study: Low back pain
    Clinical History:
    Recent Images:

    Report Status: Verified Date Reported: OCT 03, 2013
    Date Verified: OCT 03, 2013
    Verifier E-Sig:/ES/ XXXXXXXXXXXXXX MD

    Report:
    MRI OF THE LUMBAR SPINE WITHOUT CONTRAST
    Technique: Sagittal T1-weighted, T2-weighted and STIR, and axial
    T1-weighted and T2-weighted images.

    Comparison: None.

    Findings: The normal lumbar lordosis is preserved. Vertebral
    alignment and vertebral body heights are normal. There is no
    spondylolysis. There is disc desiccation and moderate disc
    height loss of L5-S1 with trace active inflammatory
    (STIR-hyperintense) endplate discogenic changes. There is disc
    desiccation of L3-L4 and L4-L5 with preserved disc heights. There
    are minor chronic fatty endplate discogenic changes at L4-L5.
    Marrow signal is otherwise normal. The conus medullaris
    terminates at L1, a normal level. The conus medullaris and cauda
    equina are normal. The paraspinal soft tissues and caliber of the
    infrarenal abdominal aorta are normal.

    T12-L1, L1-L2, L2-L3: Normal.

    L3-L4: Shallow central/right paracentral disc protrusion which
    abuts the traversing right L4 nerve root in the right lateral
    recess. No central zone thecal sac stenosis or neural foraminal
    stenosis.

    L4-L5: Mild concentric disc bulge which mildly touches the
    traversing L5 nerve roots in the lateral recesses. No central
    zone thecal sac stenosis or neural foraminal stenosis.

    L5-S1: Right paracentral inferiorly-migrating disc extrusion
    measuring 1.3 cm AP x 1.5 cm transverse x 2.3 cm craniocaudal
    which completely effaces the right lateral recess and compresses
    the traversing right S1 nerve root. No central zone thecal sac
    stenosis. Mild bilateral neural foraminal stenosis due to disc
    bulge, uncovertebral osteophytes and facet arthropathy with mild
    impingement of the exiting L5 nerve roots.

    Impression:
    1. L5-S1 large right paracentral disc extrusion with complete
    effacement of the right lateral recess and compression of the
    right S1 nerve root.
    2. Mild spondylosis at L3-L4 and L4-L5 as described above.
    3. No central canal stenosis or cauda equina impingement.
    Primary Diagnostic Code: NO ALERT REQUIRED

     
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    Old 04-05-2015, 10:13 AM   #2
    Niceguy412010
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    Re: Can I be helped with Surgery in this case? L5

    Good afternoon I saw your post and I am sure you have questions.
    1 please give me some insight to you pain is it left or right sided
    2 do you have sciatic pain?
    3 followers you have numbness in your lower extremities

    I have had to deal with multilevel. Degenerative changes for years I have seen multiple spinal surgeons and neurosurgeons and I am also able to decipher mri and ct results very fluently.
    Please let me know the information above and I think I can provide you some possible insight

     
    Old 04-05-2015, 04:17 PM   #3
    smokee
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    Re: Can I be helped with Surgery in this case? L5

    If u can manage pain..I would not go for surgery, I would wait n try other alternatives n there are a number of them if u don't mind a litl research. The body can heal itself but u will have to watch what u dol I had a bulging n herniated disc in neck..10 yrs and they fixed themselves..I had surgery in my lumbar after 5 fractures, n it made it soooo much worse. I am now trying cold laser therapy, but I have tried everything else n nothing helped n some made it worse. If there;s no hurry..than take your time n research all other options. Best wishes,

     
    Old 04-06-2015, 11:41 AM   #4
    teteri66
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    Re: Can I be helped with Surgery in this case? L5

    The MRI is just one piece of the diagnostic puzzle. It is correlated with what is found upon physical exam and basic neurologic exam. If those exams do not reveal something much different from the MRI report, I would agree that surgery is not necessary at this point.

    Your worst level is at L5-S1 where there is a small disc bulge that is causing a bit of compression of the spinal nerve roots. This would cause pain that radiates down the back of your leg and may cause pain when walking and/or standing. If this pain becomes difficult to manage, you might want to consider surgery. It is possible it could be handled with a micro-discectomy.

    Since no spine surgery is without risk, I would wait to have it done.

     
    Old 04-06-2015, 05:41 PM   #5
    lindyflowers
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    Re: Can I be helped with Surgery in this case? L5

    I know I am far from understanding everything in your MRI but you may want to try what I am doing with the medicine ball. I was told that if I sit on it twice a day and gently bounce up and down allowing the fluid to evenly distribute and over time the pain is supposed to go completely away. I just started this yesterday when I was told about this from a rodeo rider. I have been sitting on mine all day for the most part and it has gave me more relief than I have had in a long time. I figure it cant hurt to try it. I wish I could help you otherwise. My goal is to stay far away from surgery as I can. Good Luck

     
    Old 04-07-2015, 07:23 AM   #6
    momzworkin
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    Re: Can I be helped with Surgery in this case? L5

    I would wait as long as possible before having spine surgery. There are more conservative treatments like epidural injections and physical therapy that should come before the surgery.
    __________________
    07/2006: A/P fusion L4-S1; DX DDD
    09/2009: started PM
    04/2011: Right rotator cuff tear
    09/2011: re-tore shoulder in PT- lost 30% function in shoulder
    06/2013: diagnosed with failure of L2-L3-L4

     
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    back pain, l5-s1, surgery option



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