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MRI Help from all you who have been down this road...

Started by krittylu on 10/25/2010 8:24pm

Hi! Am new to posting but have been lurking for about a month. I have had lower back pain for about 2 years that is made much worse by standing or walking, I also have pain in my left butt cheek. I am a classroom teacher and standing and walking are pretty much all I do, so I checked in with a local ortho who recommended the MRI. After, the MRI, I went to his office and he pulled up the images on the computer. He literally looked over it for a one minute "onceover" and told me I had spondylolisthesis and a bum disc and referred me to a neurosurgeon. Well, I am STILL waiting for the neurosurgeon appointment so I went and picked up my actual MRI Imaging Report from the radiologist to research while I wait.

Is this as bad as I think it is? What do you think? I'm overwhelmed with where to focus my research...so am hoping you experienced folks can point me in the right direction.

Of course, what I REALLY want to hear is that this is just a bunch of stuff that ANYONE can have on their MRI...

SO, here goes:

Findings: The lumbar vertebral body heights appear to be maintained without evidence for acute fracture. There is grade 1 anterior listhesis of L5 on S1. A subcentimeter focus of increased T1 and T2 signal within the T12 vertebral bodies may represent focal fat or perhaps a hemangioma. Moderate intervertebral disc space narrowing is noted at L5\S1. Degenerative endplate changes are also seen involving L5 and S1. Anterior endplate spondylosis is demonstrated at L3 and L4.

L1\L2: No significant central canal or neuroforaminal stenosis is identified.

L2/L3: No significant central canal or neuroforaminal stenosis is identified.

L3/L4: No significant central canal is appreciated. There are mild degenerative facet changes with mild bilateral neurooraminal stenosis.

L4/L5: Broad-based posterior disc bulge with bilateral facet arthopathy resulting in mild central canal and mild bilateral neuroforaminal stenosis.

L5/S1: Broad-based posterior disc bulge with bilateral facet arthopathy resulting in mild moderate central canal and moderate bilateral neuroforaminal stenosis.

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5 Responses


Dear Krit,
I am hearing you about back pain. It is muddy waters at best to navigate. I am an RN (pediatric) and am having difficulty with this as well even with having some medical background. I just stumbled on this site this morning. I am 53 female and was rear-ended in Feb and have disc injuries in cervical, thoracic, and lumbar. Lumbar is most common and you should be able to find some help. I will give this advice: NO CONVENTIONAL surgery if possible. I am looking into minimally invasive endoscopic surgery. Google it for your city. They are out there. What city are you? I have found them around the country just not my city! (Roch, NY). They are NOT alike. Some of them do a lot of marketing (Laser Spine, North American, Bonati ect). Money is an issue too. Some insurances pay for some of it and you have out-of-pocket expenses possibly for the rest. Best to find a neurosurgeon and one who has hospital affiliation. Be "devil's advocate" and look up "lawsuits" for the surgeon you are considering. Have you done conservative things first? or even any spinal injections? I've been doing conservative therapies (PT, pool, chiro, acupuncture, inversion table, traction, laser) and am now doing injections (not helpful yet). Therapies are only temporary relief. Inversion might help your lumbar. It gets me out of bad pain. "hanging" in the pool does too (leg weights in the deep end). You can email me: my name above + @frontiernet.net . I am not sure how often I'll check in here, this being my first day.


Hi Krittylu,
All of a sudden last summer, I started having severe back pains, the worst being in my left butt cheek. Outside of a few bouts of sciatica over the years, I had never experienced anything like this. My doctor sent me to physical therapy, which only increased the pain. Then I had an MRI, and my results were something like yours, spondylolisthesis, lumbar spinal stenosis, degenerative arthritic changes, disc problems and on and on. It took many weeks to get to see a neurosurgeon and she flippantly also did a "once-over" of my MRI films and said, "Hey, I am a neurosurgeon, and I like surgery". I asked a few questions, but she gave me no other options.
I was feeling very discouraged about my situation, plus the fact that the surgery would be a years recuperation. Also, I knew of very few people who had successful outcomes on back surgery.
Then one evening, the sister-in-law of a friend called and told me about the neurosurgeons that she worked for, something I did not know. She recommended another neurosurgeon and helped me get an appointment. I live in the Milwaukee, WI area, and one of the hospitals has a back program. I saw this other neurosurgeon, and had x-rays. This neurosurgeon also said I would most likely need surgery in a year or two, but I went ahead with their back program anyway, even though she did not think it would help. By this time, I was actually getting somewhat better, the severe pain lasted for three whole months. This therapy was very gentle and the therapists really seemed to understand the situation. This next part, to me, helped me the most and also impressed me the most. As part of the program, you saw a physiatrist, physical therapy doctor, not psychiatrist, however by then I could probably have used that too. But he examined me, looked over all my records and said, "You know, a lot of people are running around with backs that look worse than yours, but are not having any problems". That indicated to me, and I have heard it before, that each individuals back problems are unique to them. No matter how bad the tests on your back seem to be, it doesn't necessarily mean that is the cause of your problem.
It is now a year later and most of the time my back is fine and I take no pain medication on a regular basis. I still do not know why I had that horrible bout of pain and or why it has gotten better. The physical therapist I went to, told me that most back pain gets better on it's own.
For me, surgery would be a last resort, however, none of us know what the future will be like.
Thanks for listening to my rambling. Good luck. Pat


When I was confused by my MRI report, I took it and the MRI and all xrays to a trusted friend who is a chiropractor. I knew he knew about spines and would be honest with me.

So in a nutshell he told me words like "mild" and "moderate" you don't need to rush into anything. When the term "severe" shows up a lot, things are a little more urgent.

Also. Just because you are going to see a surgeon, doesn't mean he/she will recommend surgery. It will be good, and probably put your mind at ease to talk to a surgeon.

And yes, you definitely needs a neurosurgeon, not an orthopedic. Not that I have anything against othopedic surgeons, but when its your spine, go with the expert.(one doctor told me: think in terms of building a house:.your primary phyiscan is your contactor, the otho is the carpenter, and the neurosurgeons fix your wiring)

I suffer from chronic pain, and am a true believer that surgery is a last resort. Look at all those posts here from people who have had surgery and still have pain or have had multiple surgeries, some even worse off than before. I have had the best luck with PT and acupuncture. Some people swear by spinal injections, but i didn't have much luck with them. I work regulary with a physatrist (and specialist in pain medicine)

Ask around, maybe your friends have not had back issues. But you can bet someone's friend or sister or neighbor has and might be able to give you a recommondation. Also talk to your family doctor, nurses, etc

Good luck, ask lots of questions and take notes


I'm am too trying to find information about my MRI and getting even more confused. First off, I have a pretty busy and demanding lifestyle that I'm not willing to change. Mom of two young boys, full-time Kindergarten teacher, etc. I've had "back problems" for over 15 years but was misdiagnosed ('vertabrae did not fuse correctly in childhood") So my recent episode which started Christmas Eve (cooking cleaning shopping wrapping) and still has not resolved led me to an ortho dr. who did xrays stating I had grade 2 spondylolisthesis. We started on the conservative treatment routes (PT, muscle relaxer and antiinflammatories) but I still am having issues. Recently had an MRI (ordered in response to scheduling a epidural steroid injection) and this is the last paragraph of the report:
"Bilateral spondylolysis with grade 1 anterior listhesis at L5-L1 with
associated disc bulge and mild bilateral foraminal stenosis" (I believe the L5-L1 should read L5-S!)

I have a follow up with the ortho dr. in about a week but I've been trying to find out how "bad" this back issue is. He gave me literature on spinal fusion at our first appt. after seeing the xray. I'm confused why the xray said Grade 2 spondylolisthesis but the MRI said "grade 1 anterior listhesis". Was it because the MRI is static (not flexed) and the xrays showed the spine in flexion?

My ultimate question is "is this a problem I'm going to keep having trouble with for years?" I understand no one can answer this on a forum but I'm not sure if I'm just having a "painful episode" or if things (disc bulge and stenosis) are truly pretty bad.

Thanks for any input ANYONE can give me. This mom is struggling!


I am so sorry to hear that you are still having back issues. Again, I do understand your confusion over the MRI and x-rays. It seems to me that most doctors, neurosurgeons, orthopedic surgeons are going to recommend surgery, as that is their business and probably what they believe is the right treatment. But as you can see by many of the posts on this site, it isn't always a successful solution. If only, if only, you could find someone who would give you an honest answer. At least that is how I felt about it.
I suspect that some of your problem could be your lifestyle, small children, working with kindergarteners, all jobs that require a lot of lifting, bending, etc.
Have you had any occupational therapy showing you the correct way to bend, stand, etc. for your particular back situation? I found some of those hints helpful to me. If I can find that paperwork, it might be helpful to you too.
Good luck.