Re: Explain my lower back mri
Welcome to the board. You must definitely get at least one more opinion. Be sure you are seeing someone whose practice is limited to the neck and back...either an orthopedic spine surgeon or a neurosurgeon. I am surprised you were told you need such a big surgery, especially considering your age and that there doesn't appear to be any major nerve compression.
Keep in mind that members are not medical professionals, just fellow travelers with neck and back issues who share information and suggestions...so keep that in mind as you read! I have had four lumbar surgeries, including two fusions and am now fused from L3 to S1 with additional decompression done at L2-3.
Most surgeons do not like to perform fusions on their younger patients unless there are absolutely no options. This is because a fusion causes those sections of the spine to be immobile, which puts additional stress on the first segment after the fusion. This is sometimes called the "domino effect" or adjacent disc disease. Obviously the younger the person is, the more time for the degeneration to occur.
Now, regarding the MRI, first it is important to know that radiologists use specific words when writing a report that indicate "how bad" or "how much" a finding is. These are: minimal, mild, moderate and severe. Speaking very generally, doctors tend to ignore issues that are judged to be minimal or mild. Moderate issues may require some sort of treatment, but it may be conservative modalities. An issue is usually somewhere between moderate and severe before requiring surgery...in the lumbar spine, anyway.
The discs are the soft cushions that separate the bones (vertebrae) of the spine. They are composed of 90+% moisture and, as we age, they tend to lose moisture and dry out. They are subject to abuse from the wear and tear of daily living. Playing sports, lifting heavy objects, etc. can speed up this degenerative process.
As the disc flattens or bulges out or herniates, it sets up a cascade of events involving other parts of the segment at L5-S1 with the issues at L4-5 being slightly worse. The diameter of the central canal is 15mm which is wide enough to accommodate the nerves. The disc at this level is bulging and in addition, the outer layer of the disc has a tear noted as an "annular tear." This combination of changes is putting pressure on the L5 nerve...which most likely is causing pain, perhaps tingling, to run down the back of the leg...perhaps into the foot.
What specifically are your symptoms? Did you play or participate in sports in high school? Are you currently seeing a spine surgeon?
|