[jc1981]

#24227

Dear Doctor,
I am a 35 year old male, who has worked in a warehouse environment for the past 3 years. In september, i injured my lower back while bending over and moving kegs in September, 2016.
Since then, I have debilitating lower back pain (mostly on the right side of my spine), pins and needles down my right leg and a burning sensation that travels my buttocks, hamstring, calf and outside of my right foot.

Physiotherapy did not help and my doctor ordered an MRI.
The MRI report states as follows :

1. There is a transitional anatomy with complete sacralization of L5. For the purpose of this report, the proximal-most completely sacralized level is labeled L5. Alignment is unremarkable. There is no evidence of suspicious bone marrow replacing lesion. Conus terminates at inferior aspect of T12 level.
2. Rudimentary disc note at completely sacralized L5/S1 level and no evidence of central nor foramina stenosis visualized.
3. L4/L5 level there is a mild diffuse disc bulge. There is minimal central canal and foramina stenosis at this level.
4. At L3/L4 level, there is minimal right foraminal disc protrusion. There is minimal right foraminal stenosis. No evidence of central canal nor left foraminal stenosis visualised at this level.
5. At T11-L3 levels no evidence of disc budge is seen. No evidence of central canal nor foraminal stenosis identified.
6. At T10/T12 level, there is minimal diffuse disc budge with minimal central canal stenosis. No evidence of foraminal stenosis is visualised at this level.
7. There is partially visualized at least 3.1 cm right iliac crest area with increased signal, non specific, may represent a small area of fibrous dysplasia.

My family doctor seems to think that my spine is fine and my injury is soft tissue injury. However, my lower back is extremely sore, particularly when i am sitting down for more than 20 minutes, standing more than 1 hour, i get pins and needles in my leg and my back gets extremely sore.

My question is, are my symptoms consistent with complete sacralization of L5 or is it just a muscle injury ?

Thank you for your response.

[jc1981]

#24228

Another question I have is, are my symptoms, in your opinion, probably caused by work-related injury or is it congenital ?

Thanks & Much kindness,
JC1981

[Donald Corenman, MD, DC]

#24234

There is no comment on this report of facets. You might have degenerative facets that were not recognized. You also have multilevel degenerative disc disease which was probably aggravated by the work comp injury. There is no comment on any significant nerve compression on the right but there is some evidence of right L3-4 problems (” minimal right foraminal disc protrusion. There is minimal right foraminal stenosis”). This radiologist notes “minimal” and size is in the eyes of the beholder.

The sacralization has nothing to do with this condition and I believe it is work comer related.

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.

[jc1981]

#24236

Thank you doctor for your response. Do you think the fibrous dysplasia on the right iliac crest can be the culprit to my pain ?

Thank you so much
-JC

[Donald Corenman, MD, DC]

#24281

If the fibrous dysplasia is small and embedded into the pelvis, there is very little chance that this is causing pain. It is probably an innocent bystander.

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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