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Help understanding report

Started by Qwiksting on 01/23/2019 4:57pm

This MRI report, I dont understand the lingo. Is this severe, something to be concerned with? The Nurse called me from my General Docs office today. She is setting up a consult with pain management, and suggested “shots” in the affected are. L5-S1 maybe?. I have had previous experience with “shots” as I eventually had to have an ACDF C5-C7 2 1/2 years ago. Shot burned like hell, hurt like hell, and was effective for like 2 days. This was in my shoulder neck area. Once my neck surgery was done, 3 months it was feeling a lot better. And now my neck is fine except for weather changes. . Now I have lower back issues. This is the report and Doctor “Talk” from my MRI yesterday. I wonder If I should get my Neck (ACDF) surgeon Doctor involved with this as well as go to Pain Managment.

Findings:
The limited disc protrusion central and bilateral paracentralobserved previously has dehydrated and retracted some posterolatterally to the right; the mild bilateral ligament up flavum hypertrophy is again apparent: moderate encroachment of the left foramen and limited crowding towards the left extrathecal S1 root; very slight effacement towards the right; correlation as to effect; the intrathecal and exiting L5 roots in the widely patent canal and recesses are otherwise unremarkable; chronic appearance.

Limited to mild gradual rotary scoliosis pattern confirmed; slight compensatory endplate findings generally away from the canal towards mild L1-2 and without encroachment concerns or any other concerns from T10-11 through L4-5 and at the sacral level through mid S3; limited rudimentary disc at S1-2.

Impressions:

At L5-S1 slight dehydration and retraction of the slight limited known disc protrusion posteriorly at L5-S1; persistent crowding toward the left S1 root with contribution from mild bilateral ligamentum flavum hypertrophy as discussed; extreme slight effacement towards the right S1 root; diminished;correlation;chronicity.

2. Underlying mild scoliosis; compensatory endplate findings away from the canal; otherwise unremarkable and stable exam.

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Hi, Quiksting—You sound very much like me! Same ACDF for same cervical vertebra, same surgical results, same period of time before lumbar pain made me look for options! I ended up with an open laminectomy and fusion of L3-L5. Your problems may be limited to L5-S1.

You need to know that lumbar surgery can be vastly different from cervical. According to my surgeon, this is the biggest surgery you can have. My post-surgical pain was insanely bad! Needed much more pain meds and for much longer. I’m 21 months out and my pre-surgical pain is mostly gone, but I still have pain, just different!

My understanding is that once they fuse lumbar vertebra, your body has to adjust to the “mechanical” changes in weight-bearing and the way you will walk. That takes a lot of time and patience to resolve. After 20-30 min. of walking, I still get mild to moderate pain in my lower back and numbness in my thigh. Both resolve within 10 minutes if I sit down. I really expect improvement to continue for the next few months at least, though slowly.

My surgery may be very different from what you might have done, but I hope to spare you the surprise I felt when it was a much, much bigger deal than my ACDF! Take your time, if you can, and try all the alternative treatments you can before you give in to surgery. Best wishes!

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Bonnie, what symptoms did you have that caused you to go the surgical route? Did you try injections?

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Quiksting, I had had lower back pain now and then for many years that was better with heat or ice. Then I began having severe numbness and aching in my upper front thighs. I began about 1 hr twice a week on the treadmill. It did not help! In fact my calves began to hurt like constant muscle spasms. It got to be where I couldn’t walk more than 5 min without severe leg pain. I tried chiropractor, physical therapy, therapeutic massage, heat, ice and water aerobics. Finally I saw a physiatrist who ordered an MRI, nerve tests and then an epidural injection which did not help at all. I then saw the neurosurgeon who had done my ACDF and who I totally trust. He said that the DDD that caused my neck surgery was the same thing happening in my lumbar spine. That made sense to me! I saw no reason to think that alternative treatments would help.

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Quiksting- I forgot to mention that my lumbar MRI showed spondylolisthesis (unstable vertebra slipped out of alignment with each other). Another big reason for my decision for surgery!

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