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    Old 04-07-2004, 11:52 AM   #1
    P4ul
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    Question MRI Report and Lower Back Pain, Help

    Hi everyone, I am really hoping that someone can give me some answers to my problems, and I apologise if this question is somewhat long. Over a year ago I had a fall at work and have not been able to return to work. My employer has admitted liability and my solicitor is dealing with that. I was referred to a specialist orthopaedic surgeon who was quite accurate with his clinical diagnoses; I then had an MRI scan, which stated that I had:

    L4/5: moderately degenerate disc with a posterior contained annular tear and a broad based disc bulge indenting on the thecal sac, but not causing any significant neural compression. Significant facet joint arthritic changes and moderate ligaments atrophy also noted at this level with modest decrease in canal dimensions.

    L5/S1: Degenerate disc with moderate decrease in disc height and end plate changes. There is a focal posterior left paracentral disc protrusion impinging on the proximal left S1 nerve root. Normal L5 exit foramina. Moderate facet joint arthritic changes also noted.

    Sagittal T1 and T2 sequences. Axial T1 sections through lower three disc levels and T2 sections through L4/5 and L5/S1 disc levels.

    Lumbar curvature and vertebral body alignment is normal. The cord terminates at D12/L1 level. Normal appearances of the D12/L1, L1/2 and L2/3 discs. Moderately degenerate lower three discs between L3 and S1.

    L3/4: Moderate disc dehydration with preservation of disc height. No central disc protrusion or herniation; no significant neural compromise.

    The Orthopaedic surgeon, who by the way specialises in the KNEE wrote a second report that said basically I had no problems with my back, in fact his report said that I had no disc protrusion and that my symptoms are related to a degenerative disc, most probably consistent with my age. You cannot imagine how I felt after receiving this report telling me that I had no problems with my back, but I still had all this major pain.

    The Orthopaedic was asked to look at the MRI again and he came back with a completely different report this time and stated that the annular tear would be attributable to the accident, but only noted the focal posterior left paracentral disc protrusion impinging on the proximal left S1 nerve root.

    He also said that I would have been symptomatic in the lower back and that this accident has not resulted in a disc prolapse but also may have accelerated my degenerative changes in the back by a period of 3-5 years. He also states that I would benefit from a referral to a spinal surgeon ant that my symptoms would improve with a facet joint injection/decompression although in view of my generalised degenerative changes and arthritis in the facet joints, surgery may have limited success.

    Could anyone express a view of my condition, I know that I have degenerative discs, but at 46 surely you would expect this in your back, please help, thank you.

    Last edited by P4ul; 04-07-2004 at 11:54 AM. Reason: used same word twice

     
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    Old 04-07-2004, 12:27 PM   #2
    injured betty
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    Re: MRI Report and Lower Back Pain, Help

    P4UL:

    First of all that is great that you got a second opinion. I think that one should get more than one or two opinions. It took me several to finally find relief.

    The nerve impingement should be your first worry. It can cause nerve damage if not treated. By no means should surgery be your first option, though, it should ALWAYS be your last.

    JUST SAY NO TO EPIDURAL SHOTS, FACET BLOCKS if they contain steroids, and always ask for information on any shots that they offer you so that you can go home and research them on the net. You have a powerful tool by having the net. Read The Burton Report. You can find it by surfing the net.

    One of the first things that they will offer you is a shot. Refuse it. Ask for an EMG to see where the pain is coming from. Also, say no to the Prednisone. It is worse on your body than the cortizone. Most people will do anything for relief but research has shown that is short term and does destroy tissue.

    Arthritis is normal at your age as it DDD and herniated disks. If they don't impinge on a nerve then you are okay. It looks like one of yours does. There are a lot of alternatives to the shots and surgery.

    The first thing that you need to do is to see an Neurologist.

    Decompression means some kind of surgery. Research you options. Read the back boards and about all of the failed surgeries. Also, go to the pain management boards and read about it there.

    With gently stretching, Yoga, Tai Chi, Pilates, and conservative therapies you can do this w/o surgery.

    I did mine with Prolotherapy. My back is now fine. I have DDD, bulging disk, and had sciatica, but with therapy I am now pain free. I am on Neurontin. No pain pills.

    You mentioned problems with your ligaments, Prolotherapy addresses those issues.

    Your MRI looks pretty normal for a person who is your age except for the protrusion. Is it a tear?

    Tears can heal on their own in about eighteen months.

     
    Old 04-07-2004, 07:14 PM   #3
    carol632
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    Re: MRI Report and Lower Back Pain, Help

    [COLOR=DimGray][FONT=Tahoma]It's nice that the second time around the ortho amended his report; however, I would suggest seeing at least one more ortho and a neurosurgeon and take your films with you.

    The problems seen on your MRI need follow up care. I agree with betty to avoid steroid shots; they are not always as safe as they are cracked up to be and can cause some serious problems.

    Carol[/FONT][/COLOR]
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