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Canadiansister 06-20-2013 12:05 PM

spondylolisthesis MRI Results!
hi all;

i'm a 47 year old woman with spondylolisthesis.

I had a real tough go with this a few years back - at that time got my initial diagnosis and finally got into a "remission" for lack of a better word. Since then I have become physically fit, going to the gym 4 times a week, doing Boot camp programs and high intensity interval training..
Went on vacation this winter and came home with back pain. Since then I've gone right back to where I was years ago. Serious trouble with pain, no help from all the typical meds - anti-inflamatories, muscle relaxants, physio - nothing has helped much. I have pain when I sit, stand, walk, the couch and my heating pad are my best friends right now.

had x-rays in early May - with the following results: There is evidence of Grade 1 Anterolisthesis of L5 on L5 with evidence of bilateral spondylolysis seen at the same location, there is moderate /sever degree of disc degeneration of the L4 level as well. no evidence of Wedge compression fracture.

Had MRI and got results today
L5-S1: There is a grade 1 anterolisthesis on L5 n S1. there is no significant foraminal stenosis seen.. There is moderate bilateral neural foraminal stenosis noted. There is also endplate sclerosis and edema noted at this level.

The vertebral body heights are preserved, there is disc space narrowing with desiccation noted at L5 - S1 level.

So after my MRI my doc tells me theres nothing that can be done. He can't refer me to a specialist since there isn't anything in the report to treat... I'm at the end of my rope. I don't know what to do.

Anyone have any suggestions....

ps I'm Canadian (as the name says) and as such have access to doctors but a referral is required and with the mri - my GP said no help from Neurosurgeons....

Last edited by Canadiansister; 06-20-2013 at 10:53 AM.

teteri66 06-20-2013 03:12 PM

Re: spondylolisthesis MRI Results!
[B]there is no significant foraminal stenosis seen.. There is moderate bilateral neural foraminal stenosis noted[/B]

Was this explained to you? It makes no sense to me as the two things are the same to me...and one can't be moderate if the other is not least from how we would word things in the US. The nerves get squished if there is narrowing in the foramen. Another word for foramina is the neural-foramina (foramen is plural)...It would make a big difference because moderate stenosis at this level could be very painful and cause lots of radicular pain down the leg.

A Grade I spondylolisthesis is the least amount one can have, but if it is actively slipping it can be very painful. I had a fusion for a Grade I retrolisthesis....and personally, I cannot imagine doing all the physical activity you describe with even a Grade I spondy.

Since you have nerve pain, or at least I assume you won't get much relief from pain meds but it might help to take a "nerve pain" med like gabapentin (Neurontin) or Lyrica. The only thing that made me able to cope with my situation was that my pain would go away when I saw down or got the weight off my feet. But I gather you don't get relief from any that correct?

I guess in Canada they must not consider spondylolisthesis a reason to have surgery. Have you had a recent flexion/extension x-ray to see if your spondy is active (creating instability)?

Welcome to the board. I hope we can help in some small way.

Canadiansister 06-20-2013 04:46 PM

Re: spondylolisthesis MRI Results!
Thanks for replying Teteri66 - I was confused by that very line (there is no significant foraminal stenosis seen.. There is moderate bilateral neural foraminal stenosis noted) That was word for word from my MRI report... No idea why. did I get explanation no not really.

prior to todays appointment my Doc was convinced I should have surgery but now is saying nothing can be done. The physiotherapist has said I have way too much movement in my spine with visible lordosis. So with that I'm guessing that it is active. He's not even willing at this point to have me do any exercises because of the pain I'm still suffering. So far the only thing that has helped is an inversion table and ultra-sound therapy, they have helped with the muscle spasm's.

I was pretty upset today when my doc told me - sorry but your going to have to live with this... I came home in tears.. can't imagine living the rest of my life like this. I'm was a very active person and now I'm basically useless. We've had to cancel our summer trips cause there is simply no way I can ride on the back of our Harley, hell I can't sit in a car for the 20 minutes it takes me to get to the office without pain.

I'm hoping that talking to others with the same or similar conditions might help me come up with some suggestions for my doc. Hes at a loss!

We have a friend at our cottage who's a doctor, we're going to go visit this weekend and press the boundaries of friendship and ask him for his opinion.. Maybe he can give us some suggestions.

did you try injections? I was completely against that sort of thing but now am wondering if that might be a viable option for me.

teteri66 06-20-2013 07:15 PM

Re: spondylolisthesis MRI Results!
I can tell you what I have learned when researching my own condition. I had a Grade I spondy and it didn't look all that bad on x-ray...and was barely noticeable on MRI. My first doctor completely missed it and said my MRI "looked fine" for someone my age -- in other words I showed a bit of "wear and tear" but many others of my peers would have a similar MRI. When I went to my first spine surgeon, and in my case I prefer fellowship-trained orthopedic spine surgeons to neurosurgeons, he looked at my MRI for about 15 seconds and sent me across the hall for the flexion/extension x-ray, which clearly showed the spondylolisthesis.

Then he told me that the only thing that would resolve the spondy was a one level fusion (mine was at L4-L5). I didn't need to have the surgery right away. I could wait. It was just a matter of how much I could handle the pain. But the only solution was a fusion. I waited several years and consulted with seven more spine surgeons, hoping to find the one doctor who would tell me there was an alternative to fusion surgery...but they all said the same thing. The only disagreement was one how many levels needed to be fused.

As you probably know, riding a motorcycle is not a healthful activity for your spine...and if you were to have surgery, no doctor would tell you otherwise.

Did the MRI report comment on the severe degeneration at L4?

Did your summer plans include coming to Milwaukee for the 110th anniv. party for Harley?

Canadiansister 06-24-2013 07:42 AM

Re: spondylolisthesis MRI Results!
Its funny - but no the MRI made no mention of the Disc deterioration at L4 as the x-ray did. And on top of the confusing and somewhat contradictory statements in the MRI - it actually is even talking about a different location. Everything up till this report indicated my problems were at L4-L5 and this is talking L4-S1 - Never has S1 been involved.
I'm at a loss - and I have to say that in this city getting a second opinion is near impossible. We have a serious shortage of doc's and as it was I was looking at going to see a specialist about 7 hours drive away, as we don't have a spine specialist in the city I live in - the nearest would be 3 1/2 hours away and I wouldn't let them touch me.

So herein lay's my problem, I'm stuck here with no help and I honestly don't know how I'm going to get through to my doctor that my issues are serious.

As for the trips on the bike, this summer -- we were heading towards Toronto and Niagara falls this year. Appears that this will NOT happen. :(
Our Harley is a Touring model with a seat like a couch... Its very comfortable but sitting isn't at this point.

[QUOTE]MRI Lumbar spine:
History: lumbar spine pain with right sciatica
Multiplanar multi-sequential images of the lumbar spine was obtained.

There are 6 non-rib bearing lumbar vertebrae with lumbarisation of S1.
The conus ends at L1 level. Visualized portions of the cord demonstrate normal signal intensity and morphology. The vertebral body heights are preserved, there is disk space narrowing with desiccation noted at the L5-S1 level. There is grade 1 anterolisthesis of L5 onS1. Bone marrow signal intensity within normal limits. Sagittal images from T12 to L4 demonstrate no significant central or foraminal stenosis.

L4-5: No significant central or foraminal stenosis

L5-S1: There is a grad 11 anterolisthesis of L5 on S1. There is no significant foraminal stenosis seen. There is moderate bilateral neural foraminal stenosis noted. There is also endplate sclerosis and adema noted at this level.

L5-S1 No significant central or foraminal stenosis.


Now as I read this - I'm more confused. One line says there is a problem the next seems to contradict it. ???

teteri66 06-24-2013 11:49 AM

Re: spondylolisthesis MRI Results!
[B]Now as I read this - I'm more confused. One line says there is a problem the next seems to contradict it. ???[/B]

Yes, that's what I got out of it, and why I was confused and don't feel comfortable trying to offer some suggestions. I think perhaps maybe the reporter got thrown off by the "extra" vertebra that you had...maybe wrote it and then forgot about it when figuring out just where the trouble spot is!

[B]There are 6 non-rib bearing lumbar vertebrae with lumbarisation of S1.[/B]

Did we talk about this in previous posts? I don't recall it if we did. This just means that you are part of a relatively small number of people that are born with a sixth vertebra that is partially attached to the first sacral vertebra. Usually this is not a pain generator, BUT that is not to say that it can NEVER cause pain or issues.

It is always pointed out though so doctors will be aware of it. It is nice to know when a doctor is doing an injection or surgery and "counts" the vertebrae to find a location for a needle or knife, etc. If he assumes you have the usual five vertebrae, it could result in treatment placed at the wrong level.

This report indicates that there is nothing wrong at L4-L5.

Now that I read this report yet again, and more carefully, I think this 6th vertebra is the source of the doctor's (or whoever reads the MRI and writes up the report -- in the US that is always a radiologist, a doctor of radiology) confusion. Your problems are at L5-S1 and it is the "lumbarized vertebra" that shows " No significant central or foraminal stenosis. "

I bet that's it.

This report would lead one to believe that the disc at L4 is fine. The disc space is normal and there is no stenosis at this level.

There are some places in the US where you can send your MRI and they will review it and provide a report. I believe the Cleveland Clinic still does that...and several of those "laser spine clinics" that advertise all the time, advertise getting a "second opinion." I would never recommend going to one, but it might be a way to get a reread of the MRI without riding 7 hours.

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