Yet another MRI Interpretation
 

I am a 51 year old female experiencing lower back pain for several years. I was finally able to get an MRI, and neuro discussed surgery. I just don't know what it all means and would appreciate help interpretating and understanding if the possibility of permanent damage exists. I understand the diagnoses of spondylolethesis, but what is everything else here? I am unable to sit or stand for very long, and my left leg to my foot frequently tingles. Following is the text:

MRI LUMBAR SPINE WITHOUT CONTRAST 7/8/10
Comparison is made to conventional films of the lumbar spine of 1/26/10 and 7/23/09

INDICATIONS 47 female with back pain. The conventional films of the lumbar spine demonstrated increasing anterior displacement of L5 on S1 as compared to the earlier study of 7/23/09.

FINDINGS
ALIGNMENT There is anterior displacement of L5 on S1 by 9mm
CONUS MEDULLARIS Normal
SOFT TISSUES There are incidental right renal cysts
VERTEBRAE There are no compression fractures. There are several foci of high signal intensity , primarily in the L3 and L4 compatible with incidental benign hemangiomata. There is irregularity of the endplates at T11-12, T12-L1 and L2-3 compatible with Schmori's nodes.

LUMBAR DISK LEVELS
L1-2 There is disk degeneration. There is no local disk protrusion.
L2-3 There is minimal disk degeration. There is bulging of the annulus.
L3-4 There is no significant abnormality.
L4-5 There is disk degeneration. There is bulging of the annulus. There is mild facet and ligamentum flavum hypertrophy, right greater than left.There is bilateral foraminal narrowing.
L5-S1 There is disk degeneration. There is bulginf of the annulus.There is prominent bilateral foraminal narrowing, left greater than right with impingement upon the L5 nerve roots, left greater than right. There is also central spinal stenosis. There may be mild impingement upon the right S1 nerve root in the spinal canal.
CONCLUSION Severe disk degeneration at L5-S1. Anterior displacement of L5 on S1. Prominent facet and ligamentum flavum hypertrophy with sever bilateral foraminal narrowing, left greater than right with impingement upon the L5 nerve roots, left greater than right. Probable impingement on the right S1 nerve root in the spinal canal.

Disk degeneration , bulging annulus and facet and ligamentum flavum hypertrophy at L4-5.

Did the neuro not discuss the findings in the MRI?

I have herniated discs in my cervical spine, one pressing on the C7 nerve and I've been in utter agony, have tried PT, steroid injections etc and am now back in PT and might be looking at surgery.

It is worrying not knowing what an MRI is actually saying but a specialist needs to read it and explain everything to you, all the best and hope you get answers.

Hello RasGirard
 

Sorry you are having back issues. So many of us do. I read your MRI. I am not a professional, however I do look up things extensively. Most of us get some degenerative changes as we grow older. When your MRI says that you have nerve impingement on the nerve root, as you do in L5 and Probably in S1 that most likely is the real source of your pain. Anytime that nerve root is touched it is agony. Seek a second opinion no matter what you decide to do. Surgery is always a last resort. Try a number of therapies before you decide on the surgical approach. If the second neurologist says you need the surgery, well, then you must decide on what to do. I know it isn't fun to go through. There can be good outcomes to surgery. I will be here to listen. ginnie:grouphug:

Hi sitke
 

Are you experiencing arm pain? C7 is where some of my trouble was too. ginnie

Hi ginnie,

Just replied on my post and then saw this...

Yes, my left arm is very painful/tingly and I get sharp shooting pains in my left bicep, forearm and middle fingers.

Are you having these problems??

Hi Sitke
 

Yes, I had that pain too. Got so bad I couldn't hold a toothbrush. I have had two fusions, C6-7, then C3-7 the second time around. The C6-7 didn't support the ones above it, called the domino effect. That is one of the reasons to go for another opinion too. If you do have surgery to correct, the vertebra above and below need to be strong enough to support the bracket and screws. My surgery did turn out good all in all. It was very hard to go through however, as I did reverse the curve of my neck. Healing was slow and painful.
It was worth what I went through to have little pain now. What ever you decide to do, make sure you have great communication with your doctor. I sure hope that you can find the right resolution to make your life better. ginnie:grouphug: