I know a lot of people ask for help interpreting MRIs, so i am adding to the group - appreciate any feedback.
I had a large metal gate fall on me over 5 years ago. I have had several non-invasive procedures (disc biacuplasty at L5-S1 in 2008 and L4-L5 in 2010 - first provided relief for about 6 months, no help from the second), as well as more injections than I can remember. Medication was managing pain for the last year or so, but I started traveling (think 24-36 hours on a plane) again recently (new full-time job) and my pain has since increased significantly, I find it hard to stay focused to get any work done and have a new symptom of sciatica down the left leg.
I recently got a new MRI and this is what it says:
At L4-L5 there is annular disc bulging which flattens the ventral margin of the thecal sac and is seen in association with facet hypertrophy. However, no resultant central or foraminal stenosis is seen.
At L5-S1 there is a right paracentral herniation with impingement upon the right S1 nerve root within its lateral recess. Previously at this level there was a left side disc protrusion.
More diffuse disc bulging at this level does cause encroachment within the indoor right neural foramen as well.
At L1-L2 mild annular disc bulging is identified without significant central or foraminal stenosis.
At L2-L3 and L3-L4 no significant neurocompressive changes are seen.
The vertebral bodies do maintain normal height and marrow signal changes.
The conus medullaris is at the L1 level and displays normal morphology.
Right paracentral disc herniation at L5-S1 with impingement upon the right S1 nerve root.
Annular disc bulging at L4-L5 which flattens the ventral margin of the thecal sac.
As i mentioned, pain had gotten worse, sitting is difficult and I have started to have sciatica - which is a new development. Also, is it weird that the protrusion at L5-S1 would change from the left side to the right? (I had this MRI at a different location than my last few, so they had my previous reports, but not films.)
I've been seeing the same pain management doctor for over 4 years. He is great, but always good to get some input/advice/feedback from others.
Would appreciate any comments, but would really like to know what others think these results would suggest as next steps.
Thanks so much!