[LisaE]

#35509

Hi There
I am 5 years post op for a two disc repair and am at the point where i need to figure out next steps as a day doesn’t go by that I am not in pain. With both L4/L5 issues, is a fusion not worth it given that it would potentially progress to L3? Pain has always been left but is traveling right. I am active and skiing is one of those activities that I do regularly.

Imaging:
X-rays
Study: 2/3/2023
Lumbar spine 4 view
Normal curvature the lumbar spine. She has a stable 2 mm anterolisthesis at L4-5. Her disc heights are well-maintained with the exception of L4-5, L5-S1 which she has moderate loss. She has facet arthropathy L4-S1.

MRI L-spine
Date: 2/8/23

Findings / Impression:
1. No now made of a 5.5 mm right paracentral disc herniation at the L5-S1 level with annular bulging. There is extension of disc material into the right subarticular recess with effacement and impingement of the traversing right S1 nerve root now noted. Left-sided laminotomy defect at this level is noted. There is endplate remodeling. There is mild right foraminal stenosis.
2. Slightly increased prominence of a now 4 mm central protrusion at the L4-L5 level. There is effacement thecal sac. Central canal remains decompressed by left-sided laminectomy. There is minor left foraminal narrowing, unchanged.
3. Slight interval progression of disc degeneration at the L3-L4 level. There is mild facet arthropathy. There is no evidence of localized disc herniation, neural element compression, or stenosis.

[Donald Corenman, MD, DC]

#35510

Is your pain lower back off to the side or buttocks and thigh pain? The radiological description is vague. Do you have a degenerative spondylolisthesis or an isthmic slip? See:

https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-lower-back-and-leg-pain/
https://neckandback.com/conditions/degenerative-spondylolisthesis-or-spondlylolysthesis/ and
https://neckandback.com/conditions/isthmic-spondylolisthesis-slipping-of-a-vertebra-because-of-fracture/

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.

[LisaE]

#35511

thanks for the response, the pain has always been low back radiating to left buttock and hamstring. Pain is now starting in right buttock. pain is constant but is of course worse with sitting. My Xray reflected that my spine was stable, not sure what that means. my first surgery was to relieve significant nerve pain radiating down my left leg and that seemed to work but now the pain is back everywhere both left and right.
I am going to submit my MRI disc to you and go through your second opinion process.

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