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  • AvatarAlaskaguy9
    Participant
    Post count: 7

    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
    identified.
    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.

    Michael

    AvatarAlaskaguy9
    Participant
    Post count: 7

    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.

    Impression

    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.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7288

    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. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    AvatarAlaskaguy9
    Participant
    Post count: 7

    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.

    Michael

    AvatarAlaskaguy9
    Participant
    Post count: 7

    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
    Michael

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7288

    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.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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