[FoxBros556]

Hello,

my name is paul.
I Just joined this site because I'm concerned about my Lumbar MRI. Below are the finds from a lumber MRI I took Aug 13, 2013.

T12-L1: No central canal stenosis. Neural Foramina are patent.

L1-2: No central canal stenosis. Neural Foramina are patent.

L2-3: No central canal stenosis. Neural foramina are patent.

L3-4: No central canal stenosis. Neural foramina are patent.

L4-5: There is a far lateral neural foraminal disc protrusion that results in a moderate narrowing of the right neural foramina. The disc protrusion measures 15*9 mm on axial image 31 of series 5. No central canal stenosis. Left neural foramina is patent.


Those are the results.

Can someone please help me understand my results and let me know how bad they are. My dr. said my L4-5 disc protrusion is cause my right leg pain and numbness in my right shin. Is that possible??? Plus i barely have any right knee reflex, which he also attributes to L4-5 protrusion. I guess I'm just worried because I've had physical therapy and 2 epidural injections and i have absolutely no relief. The pain started in my back, but now i have no back pain all right leg pain and butt pain. This has taking over my life for the past 2 months. Can someone please shed some light on my situation???? Any recommendations will highly be appreciated.

Thanks,
Paul

[Dubious]

Originally Posted by FoxBros556

Hello,

my name is paul.
I Just joined this site because I'm concerned about my Lumbar MRI. Below are the finds from a lumber MRI I took Aug 13, 2013.

T12-L1: No central canal stenosis. Neural Foramina are patent.

L1-2: No central canal stenosis. Neural Foramina are patent.

L2-3: No central canal stenosis. Neural foramina are patent.

L3-4: No central canal stenosis. Neural foramina are patent.

L4-5: There is a far lateral neural foraminal disc protrusion that results in a moderate narrowing of the right neural foramina. The disc protrusion measures 15*9 mm on axial image 31 of series 5. No central canal stenosis. Left neural foramina is patent.


Those are the results.

Can someone please help me understand my results and let me know how bad they are. My dr. said my L4-5 disc protrusion is cause my right leg pain and numbness in my right shin. Is that possible??? Plus i barely have any right knee reflex, which he also attributes to L4-5 protrusion. I guess I'm just worried because I've had physical therapy and 2 epidural injections and i have absolutely no relief. The pain started in my back, but now i have no back pain all right leg pain and butt pain. This has taking over my life for the past 2 months. Can someone please shed some light on my situation???? Any recommendations will highly be appreciated.

Thanks,
Paul

Your symptoms, exam and MRI findings are in agreement and consistent. 9mm is pretty big. You've already had ESI so discectomy may be your best bet. You can try waiting it out but the longer you wait, the more potential scarring of the nerve root occurs, possibly lessening favorable surgical outcome should you eventually go there. Please discuss thoroughly with your doc.

[FoxBros556]

Originally Posted by Dubious

Your symptoms, exam and MRI findings are in agreement and consistent. 9mm is pretty big. You've already had ESI so discectomy may be your best bet. You can try waiting it out but the longer you wait, the more potential scarring of the nerve root occurs, possibly lessening favorable surgical outcome should you eventually go there. Please discuss thoroughly with your doc.

Is a microdiscectomy and discectomy the same thing? My injury happened July 29th, 2013. Its already been to months. My pain management dr. believes surgery is my best option. I'm scheduled to see a top orthopedic surgeon at midwest orthopedic at Rush. I live in Chicago. Do you think I might already have scar tissue after 2 months?? I have to say over the past few days the pain has gotten better, but the numb raw burning feeling in my shin is still there. That pain comes and goes. Its not constant all day. I guess I'm just confused and angry at myself because i easily could have avoided this injury. Oh well, it could be worse, I guess????

[Dubious]

Originally Posted by FoxBros556

Is a microdiscectomy and discectomy the same thing? My injury happened July 29th, 2013. Its already been to months. My pain management dr. believes surgery is my best option. I'm scheduled to see a top orthopedic surgeon at midwest orthopedic at Rush. I live in Chicago. Do you think I might already have scar tissue after 2 months?? I have to say over the past few days the pain has gotten better, but the numb raw burning feeling in my shin is still there. That pain comes and goes. Its not constant all day. I guess I'm just confused and angry at myself because i easily could have avoided this injury. Oh well, it could be worse, I guess????

Pain may wax and wane...your functioning (weakness and neurological issues) is more important in determining whether surgical intervention makes sense. Microdiscectomy is a type of discectomy. Better to see either a neurosurgeon or orthopedic surgeon who is spine-fellowship trained. There are arguments whether to go ortho or neuro but I think the bigger argument has to do with whether they have fellowship training in spine or not. Each case is unique but generally for many cases that are going to surgery, they should probably go no later than 1 to 3 months post-injury. That is not to say if you wait longer that you won't get a good outcome, rather the chances of a good outcome diminish as time rolls along. Obviously severe cases need to go immediately but for the average case with some to no neurological impairment, you have time to try conservative approaches. Severe and progressively worsening cases need more emergent attention.

[FoxBros556]

Originally Posted by Dubious

Pain may wax and wane...your functioning (weakness and neurological issues) is more important in determining whether surgical intervention makes sense. Microdiscectomy is a type of discectomy. Better to see either a neurosurgeon or orthopedic surgeon who is spine-fellowship trained. There are arguments whether to go ortho or neuro but I think the bigger argument has to do with whether they fellowship training in spine or not.

Thanks for you help. I will post what my surgeon advises tomm.