Hi all! I am new to the forum and would very much like to know if anyone has had similar MRI reports on their lower lumbar, and what their doctors/medical professionals advised them.
MRI reads:
Grade I degenerative subluxation at L4-5 with bulge, annular tear, prominent facet arthropathy. Mass effect on the right lateral recess nerve root w/crowding of the left. Stress injury of the pedicle & pars region of L5.

Next Tuesday I go to a pain clinic for a 2nd opinion on surgery. Any and all replies much appreciated!!

I should have asked in my previous post.....does my MRI sound really bad to ya'll?
I know that it feels really, reeeally bad. Back hurts, right leg hurts all the way to the foot, muscle spasms in both legs are constant, right leg goes numb driving, both knees ache something awful in the backs of them.

Orthopedic surgeon rated it an 8 in severity, but he advised a laminectomy so fast that I was a bit leery of him.

Hi ~ I'm glad you're getting another opinion -- you might even want to get one more, perhaps from a Neurosurgeon this time.

Do NOT jump into surgery -- surgery should be a last resort, after all conservative methods have been tried UNLESS you're in danger of permanent nerve damage or the spinal cord is being impinged. You're never the same after surgery and surgery does NOT often relieve the pain. Many times you end up with the same pain or worse after surgery.

Best of luck - let us know what the pain doc says. Take care & God bless. Hugs, lee

I have had surgery twice on L4/L5. The first one was 10 years ago and it was laser surgery and I was ok in 3 weeks. This last one was open back surgery and has taken me an entire year to recover. I thought that every ortho uses laser and open back was a thing of the past. I was wrong because I assumed. I think the key to alot of people avoiding surgery is to strenghthen their core and back muscles. It takes 6-8 weeks. But it depends on what the specialist thinks as well. I would only use a neurosurgeon or an ortho spine specialist for surgery. Not every ortho is for spines. Surgery should alsways be last option for many reasons.

What # was your post about your MRI? ginnie

So sorry you are going through back issues. There are alot of us on here who have both had surgery, and gone the non-surgial root. Don't rush into surgery, and for sure get a neruo surgeon opinion. It never hurts to get others opinions, and I would do that first. Also look up all words in your MRI report, so you will understand better just what your MRI says. Most MRI's do sound very scarry. If you understand the exact terms, when you do go for another exam, you will understand what they are telling you better. If you have nerve inpingement pressing on the nerve column that for example is reason for a surgery. I had nerve involvement compressing the nerves in my neck and had two spinal fusions. I would never tell someone to go ahead with surgery without all the opinions you need to satisfy your understand ing of the problem. If you understand all the issues, your decision making will be alot easier. Others here may chime in, with a more complete understanding about what your MRI states. I hope the best results happen for you. ginnie

I had L4-5 fusion 5 years ago, along with a laminectomy. Still have a lot of pain; but major nerve compression would have made things much worse. The surgery was necessary in my case. Since the spinal cord was being compressed, did need to have laminia removed in that area as well.

I am currently under the care of a Pain Specialist; but not sure that would be the doctor to see for a second opinion since their primary job is to relieve pain. Too often, the Pain Specialist will start treating the pain/epidurals, etc.

I certainly would see an orthaepaedic surgeon and/or neurologist/neurosurgeon for 2nd/3rd opinion. They would be the best to give an opinion regarding your issues and the course of treatment.

ger715, thanks for sharing. Sorry you are still under pain mgmt. after all these years! The pain clinic here is staffed by neurosurgeons and ortho doctors as well. I will be seeing a dr. not a pain mgmt. specialist for the second opinion. They are all affiliated with the hospital next door to clinic so if surgery is called for it will be performed - or at least that is what I've been told. I am financially unable to argue much.

You said that you had a laminectomy...that was done prior to your fusion for L4/5? Was it a "minimally" invasive laminectomy or the traditional? I did speak with a neurosurgeon's office, one who is highly thought of in the area (also big $$), and was told that she does not do the minimally invasive procedures (like the 1st ortho wants to do on me) because the outcome to that is not as good as traditional.

ger715, you also spoke of nerve compression. My MRI states "mass effect on nerve root". Bumping around to different medical sites, I gather that compression and mass effect are interchangeable. Do you know that to be true?

As far as any epi's, I am not sure if I could ever go that route. I had a set of 3 cervical years ago, and I had a debilitating headache for 24 hours afterward -felt like my head was going to literally explode. Completely drained on the 3rd from the pain the day before. I have since found out that I am allergic to cortisone medications. Do they still perform lumbar epi's if that is the case?

Sorry for all the questions!!.....just nervous, can't sleep, & these constant nerve spasms are maddening!!!!!!!!!!

It is OK to see a pain specialist for another opinion, In fact it was my pain specialist who "discovered" just what was happening to me when he did a Katamine infussion with the xray guide. He could see what was wrong and he ordered the new MRI as he could not control my pain. It was his referal to my new neuro surgeon. I wish you all the best while you go for your evaluations. ginnie

Ginnie, thank you so much for your well wishes and for sharing your experience! Happy it worked out well for you and that you had good care.
Tuesday just can't get here soon enough!