Iv been referred to a neurosurgeon by my family doc. She basically said she wasnt sure wat was to be done about my back and leg pain w leg numbness but that the mri came back with issues so off i need to go.

I got my report, mri's, xrays, which im to take to my neuro tommorrow but i have no idea what the report means and sense my family doc didnt explain a whole lot other than "you need neurosurgeon"...i was wondering if anyone could help me decipher the mri code and tell me the basics of what to expect on my first visit.

"combination of a thickened left facet joint capsule at the L4-5 level and a bulging annulus at the L4-5 level may be causing mild compression of the left L5 nerve root as it enters left lateral recess of L5. There is old central-left disc protursion at the L5-S1 level which causes slight displacement of the left S1 nerve root. "

reads like stero instructions to me and all i know is that i have neck,back, and leg pain with numbness.

I called the office and asked question but until i go they really cant give me any idea of what the first visit will consist of which adds to the anxiety and stress levels. Just wondering what anyones thoughts and or expierence on this maybe.

Hi ~ Maybe I can help a LITTLE -- the thickening of the facet joint COULD be from arthritis -- probably osteoarthritis-- at the L4-5 level. And the "bulging annulus" is a ring-like part at that same level and its mildly compressing the L4-5 nerve root as it enters the back part of L5.

There's also an "old" left central disc bulge at L5-S1 which causes slight displacement of the S1 nerve root. Both the above and this would cause pain and can account for the numbness in your leg.

Your neuro appt. would probably consist of him looking over your records/films, and then having you do some "movements" such as walking on your heels & toes, doing the "straight-leg" test, where you lay on your back on the table, and he raises your leg while it's straight until you tell him when it starts to hurt your back. They USED to do that all the time -- maybe they don't do that anymore. I don't know. He'll also test your reflexes, etc. There may be a few other things he'll do. Other than that, that's about it probably.

Then he'll tell you what he advises. DO NOT jump into surgery, if he advises it, although I doubt he will. Surgery should be a LAST resort, after ALL conservative methods have been tried.

I wish you the very best. Let us know what happens. God bless. Hugs, Lee

well im off this morning to go and find out. I appreciate the reply takes a little stress off. Feels like im going to the gyno and im waiting on a report ..lol. I know that sounds odd but its a worrying thing i guess. if you dont know whats going to happen it builds up undo anxiety and for me that means i tense up more which as im sure everyone else knows makes you hurt more. Ill get back later lord willing and tell what the outcome for today..thank you so much for your response. it helped alot.

This is a common question, and Leesa's answer was spot-on. All I would add is that there may be a lot going on in a stressful situation, and it often helps to have someone (family/friend) with you to listen, take notes, or ask questions.

It may be moot at this point, but since it is a common question and hence likely to come up again, and in a variety of situations with different specialists (pain management, physiatry, orthopedic, rheumatology, etc.), what I've always found useful is to
Google: first visit ______ (fill in specialist - in this case, neurosurgeon).

There are always a fair number of articles (mostly in agreement) that, in addition to helping prepare for that first visit (what to bring, questions to ask, what to expect will happen, etc.) can really help put one's mind at ease/rest about that first-time anxiety.

I always try to read a minimum of three such articles - sometimes more - depending on how well they seem to be written, who's written them, and how much they agree with each other, to get a well-rounded idea (so I'm as prepared as I can be), and taking notes as I read. Let's say... enough articles that I'm feeling comfortable/confident about it.

Then I start researching & writing up my questions & concerns (what I want to be sure to mention) while the information is still fresh. I'll leave time before my appointment to review this information and add/edit as necessary.

Another common occurence is that people come (back) here after their first visit because in the stress of the situation, they were nodding their heads like a bobblehead, but they really can't remember what the doctor said, or didn't understand it. That's OK. It happens. It just points out the importance of bringing someone with you and taking notes.

At this time, it's good to remember that doctors only hear about 25% of what patients say (because they're constantly thinking about all their training & experience in the effort of diagnosing and figuring out what to do next) and patients only hear about 50% of what doctors say (due to aforementioned anxiety/stress). It's up to us (patients) to make sure the doctor hears/understands our concerns and answers our questions adequately.

Doc

So much good info. and experience here. Just another quick thought, if you find yourself in a position where you don't have a "concerned other" to go with you, take a tape recorder. My daughter who lives 2-3 hours away was unable to come up for my last appt. with Pain Man. She has a son who had all four wisdom teeth surgically removed two days before and developed two dry sockets the night before my appt. Her husband was out of town. I insisted that she stay there and get the lad in to see the oral surgeon ASAP. She was back home when I had the appt. and Pain Man let her Skype him in the office and she joined the appt. Kind of cool.

We did that on Christmas morning. The gang was up here all day several days before Chirstmas but I was alone that morning. Boo-Hoo. My daughter Skyped me just before the family was going to open the presents and I asked her to focus her I Pad on the tree area so I could watch. I was magicly transported hundreds of miles away and had a ball. So much for my quick thought. Take care.

I agree with you. What you say is very reasonable, but you should let her provide more information for your reference. Before I went to the neurosurgery in Singapore. Because my lumbar nerve is a little problem. I made a body check, result doctor told me take surgery. Now I have not restored to health.