Tagged: L5 root compression
Alaskaguy9ParticipantJanuary 16, 2020 at 7:37 pmPost count: 10
Good afternoon Dr.Coleman,
I had a ACDF C5-C7 done about a year ago and now had a updated MRI on my Lumbar spine done. The report as you can see is very short and differs very much from the previous ones, could you provide some input on this newest report?
There is no evidence for fracture or dislocation. Vertebral body
heights are maintained. The conus terminates at the L1 level. The
nerve roots have a normal configuration. No intradural mass is
The marrow signal is unremarkable.
At L5-S1, there is a left subarticular/foraminal zone disc
extrusion associated with left lateral recess stenosis and mild
to moderate left neural foraminal stenosis. No significant
central canal stenosis.
Mild degenerative facet changes in the lower lumbar spine.
MichaelAlaskaguy9ParticipantJanuary 16, 2020 at 7:40 pmPost count: 10
This was the MRI finding from last year, it seems more detailed…
L5-S1 Loss of disc signal. Mild diffuse disc bulge. Mild biteral facet hypertrophy. No central stenosis. Left foraminal disc protrusion. Left foraminal disc protrusion causes moderate to severe left neural foraminal narrowing and impinges on the exiting left L5 nerve root. Mild right neuroforaminal narrowing secondary to disc disease and facet hypertrophy.
L5-s1 degenerative disc disease
L4-L5 and L5-S1 facet arthropathy
No central stenosis
Moderate to severe left and mild right L5-S1 neural foraminal narrowing. Mild bilateral L4-L5 neural foraminal narrowing.
Flattening deformity of the exiting left L5 nerve root secondary to left disc protrusion.
Any help or giving me an idea how bad this is I would appreciate.Donald Corenman, MD, DCModeratorJanuary 18, 2020 at 1:21 pmPost count: 8455
The new report notes “At L5-S1, there is a left subarticular/foraminal zone disc extrusion associated with left lateral recess stenosis and mild to moderate left neural foraminal stenosis”.This is compared to the year-old report “Left foraminal disc protrusion. Left foraminal disc protrusion causes moderate to severe left neural foraminal narrowing and impinges on the exiting left L5 nerve root”
Your L5 nerve on the left is compressed in the foramen at L5-S1. Interestingly enough, there are some individuals who have this finding without symptoms so I assume you have left lower leg pain. Treatment depends upon the severity of your symptoms and physical examination findings.
Dr. CorenmanAlaskaguy9ParticipantJanuary 19, 2020 at 9:37 amPost count: 10
Thank ou for your advice Dr. Coreman,
I do have pain in my left leg, sometimes to the extent that my primary care provider assumed kidney stones. The pain is not just in my lower leg, but radiates from the buttocks down. I did receive epidural shots and had PT, it just seems to get worse..especially after I had the cervical fusion last year. What other treatment options are there, I just dont want to wait as I did with my cervical spine? Also, the last time I received shots in my lower back I stayed numb for almost a day from my hips down and truth to be told urinated myself several times at the hospital.
MichaelAlaskaguy9ParticipantJanuary 19, 2020 at 9:45 amPost count: 10
In addition, and I apologize Dr. Coreman
What is the difference between a protrusion and a extrusion, also in terms of severity. So I have an idea of what my doctor will recommend.
Thank you for taking your time
MichaelDonald Corenman, MD, DCModeratorJanuary 19, 2020 at 10:02 amPost count: 8455
You probably have nerve root compression causing much of your pain. You most likely will need surgery after failing PT and epidurals . The surgery is dependent on your imaging studies. If you have foraminal collapse, you would need a fusion. If you have an extruded herniation that is removable without having taking off too much of the facet (which would require a fusion), them a decompression and microdiscectomy might be all you need.
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