Lumbar Spine MRI Report Interpretation, Uninsured

[CharlesNorris]

Hi,

8 months ago, I slipped on the stairs and herniated a disc.  I have moderate to severe pain in my lower back and less-serious numbness and tingling in my right lower leg.  I am a 26 year old male and otherwise healthy with no other medical issues.  I have been treating the pain with naproxin, stretches, and exercises with minimal effectiveness.    

I am in between jobs right now and I will not have health insurance until March to consult a spine expert.  Could you help me understand the MRI report below so I can have an idea about how serious my condition is, what is the likely recommendation a specialist would make, and any other suggestions you may have?



Alignment & osseous structures: 3mm retrolisthesis at L5-5 is noted.  2 mm anterolisthesis at L5-S1 is noted

L4-5: Disc desiccation.  Disc space narrowing.  Retrolithesis.  Moderate bulge.  Right central small extrusion efface the thecal sac.  Mild hypertrophy.  There is moderate to severe bilateral subarticular recess stenosis with mass effect upon the L5 nerve roots especially on the right.  Mild bilateral foramnial stenosis crowds the exiting L4 nerve roots.  

L5-S1L Disc desiccation.  Disc space narrowing.  Mild bulge.  Small central extrusion mildly effaces the epidural fat.  Mild facet hypertrophy.  Mild bilateral forminal stenosis.  

Impression:
1.  Bulge plus a right central extrusion at L4-5 contribute to moderate to severe subarticular recess and mild central stenosis with mass effect upon the L5 nerve roots especially on the right.
2. Small central extrusion at L5-S1 is noted without nerve root compression  Bilateral foraminal stenosis crowds the exiting nerve roots at this level.  

[CharlesNorris]

Thank you for your input.  I am about 5'11'' and 195 lbs, the upper-end of my healthy weight range, but my body fat percentage is not too excessive.  My diet mostly consists of vegetables and tubers, free-range meats, eggs, organs, and bone stock, and no grains or refined sugars.  

I know there are several different types of surgeries for herniated discs, but I have heard they are best at helping with leg pain and back pain will not change much.  However, my primary problem is back pain and my leg discomfort is more annoying than painful.  Can surgery help with back pain also?

[Caryopteris]

You need to see a neurosurgeon for your situation.

You need the best neurosurgeon in the area.  I would tell that to anybody who might be needing lumbar spine surgery.  

I believe lumbar disccectomy with fusion may be recommended.  But lumbar surgery does not have results that are as good as cervical (neck) surgery, probably because of all the weight that is on the lower back compared to the neck.  If you are overweight, it is very important you start eating a healthy diet to lose weight, focusing on vegetables and fruits, no sugar and limited lean meat/fish/poultry/nuts.  Carbs should be few and only use healthy ones such as potatoes, legumes, foods with nutrition instead of cake and cookies with no value.  The less pressure on your spine the better, and it will make the surgery and recovery better also.  Do it right, not an unhealthy crash diet.  Walk for exercise as recommended and as you are able.  If surgery is not recommended, get another opinion, but back surgery should only be done when certain criteria are met.  A good neurosurgeon will explain the options and the pros and cons.