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  • Hutchinson
    Member
    Post count: 4

    Dr Coleman,

    Your videos are so much help, thanks so so much.

    here is the hospital MRI file (sequential) of my back MRI taken in China that I had them give me

    box.com/s/dc4a8fb469da4595ba96

    please can you help explain the issues as I didn’t understand the chinese doctors.

    Age:31 Height:6,1 weight:170lbs Health:Good

    I have tried rest/healthy living and giving my body time to heal for 1 year but it has failed.

    Near Constant pain down the left leg, especially upon standing

    Sitting for more than 5minutes leads to a severe lack of flexibility upon standing, radiating pain around the lower back and shooting pain down the leg

    Flares up around once a month leaving me basically bed ridden for a week then I can move around and walk freely but with leg pain

    Hope you can give me your advice here on this one as I can only see surgery left as an option now to fix that L5-S1 problem.

    Again thanks so much for your time and I really hope you can help

    Regards

    Sven.

    P.s I took Roaccutane (accutane) as a teenager leaving me with poor healing ability hence my reluctance for surgery so I would be looking for the latest least invasive surgical method.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    I generally cannot open and read internet files regarding imaging. I can tell you at this point that I have yet to learn Chinese and will not be able to read the Chinese radiologist’s report.

    By your description, you have a radiculopathy- most likely of the L5 or S1 nerve. The most common cause of that is a herniated disc. If you have no motor weakness, you could be a candidate for epidural injections and physical therapy.

    If in China you have no resources for that, you could try non-steroidal anti-inflammatories or see if you can take an oral steroid prescribed by a physician. If you have had pain for a year, I am not sure that reliable improvement can be expected with conservative care.

    Dr. Corenman

    Hutchinson
    Member
    Post count: 4

    Thanks for the reply Dr Coleman.

    That file is the standard MRI images from the MRI machine not the report. There is no Chinese.

    I just wanted you to take a look and tell me what you think of the structure of my back.

    They are the ones that the radiologist use for their report and then put onto the MRI film prints.

    In fact they are actually just as clear if not clearer than the actual film print.

    Please could you take a look. I don’t mind paying if that would help here.

    Regards

    Sven.

    p.s I know the L5-S1 is herniated and hasn’t recovered itself which I was hoping.

    The L5-L4 and L4-L3 are degenerated and bulging from the looks of it.

    I need to know any other issues there are and if there is any way of that L5-S1 recovering without surgery.

    I believe it is only going to get worse and leave me unable to walk. If there is another option to fix the issue (I don’t mean pain relief here but a solution to that huge herniation) that I will do everything to achieve it. :)

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Again, I generally cannot access images on the internet. Please feel free to send me your images via Fed Ex or DHS. I can comment on radiological reports but the caveat is that the report is through the eyes of the radiologist and important findings may be misinterpreted or missing.

    If you have had pain for one year or longer, the pain matches the level and side of the disc herniation (right L5-S1 HNP should cause right sided leg pain that can radiate to the foot) and there are no other potential causes of this pain, a microdiscectomy of L5-S1 should be considered. Because of the length of time of compression of the nerve root, pain relief after surgery may be less reliable because of the potential for chronic neuropathy (chronic radiculopathy- see website for explanation).

    The degenerative changes of L3-4 and L4-5 are part of your genetic make-up (see section on lumbar degenerative disc disease). You have no significant reported lower back pain (consider yourself lucky) despite these degenerative discs. These do not factor into your current symptoms and whether or not they give you problems in the future, do not be concerned about them now.

    Dr. Corenman

    Hutchinson
    Member
    Post count: 4

    Hey Dr Coleman,

    Sorry to bother you on the weekend,

    I am confused here, the link is the file just like you would receive via email you just download it, I can send the file to your email if that puts you more at ease.

    These are not ‘internet images’ but the original MRI images.

    If you take a look at the images and can honestly tell me that they are not of high enough quality (they are of the same quality as the MRI film) I will not bother you any more.

    This is how documents are now passed between people.

    Please please help me here just to take a look.

    They are crystal clear sequential MRI images identical to the MRI film

    Sending the images via fedex would be a nightmare for me to get them back here into China as I doubt they would arrive. And are no different from what I am trying to give you now.

    Thank you for taking the time with these replies… One look at the MRI images and I am sure you will know exactly my problems, in fact I guarantee it as even I can see most of the problems but need some help with clarification.

    Regards

    Sven.

    Here is a screenshot of one of the images (obviously this has lost image quality as it just a screenshot)

    screencast.com/t/S3xov0nrf

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Although my policy is not to access internet files as viruses are not uncommon, I did try to access that file and cannot gain access. If you could type the report from the radiologist on the forum, I could give you my opinion.

    Dr. Corenman

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