MRI Results Opinion

[Gordo78]

I recently MRI done on the lower back region.  I have now seen a spinal docter and am being referred to a spinal surgeon,
I just wanted to get your professional opinion on the findings.

Patient a 30 yr old male,
Gordon
Routine L-Spine
Findings the patient has a developmentally narrow spinal canal with superimposed degenerative changes.

At L3-4 level there is a diffuse disc bulge causing indentation of the thecal sac with bilateral degenerative facet changes as well as ligamentum flavum hypertrophy contributing to cause moderate degree of central canal stenosis. There is also mild foraminal narrowing bilaterally without caising definate nerve root impingement. At the L4-5 level there is a diffuse disc bulge in combination with ligamentum flavum hypertrophy and degenerative facet changes causing a severe degree of central canal stenosis. the foramanal zones bilaterally show minimal narrowing without causing any definate nerve root impingement.

At the L5-S1 level there is a diffuse disc bulge with a posterior annular tear centrally causing indentation of the thecal sac.  There is a very mild lateral recess stenosis more towards the left without causing definate nerve root impingement. Mild facet degenerative changes are seen. Mild left sided foraminal narrowing seen without causing any definate root impingement. THe spinal cord ends at normal level conus and cauda equina nerve roots.

Impression:
Multilevel degenerative changes in the lower lumbar spine worst at L4-5 level causing severe degree of central canal stenosis and to a lesser degree at L3-4 level as described.

there is a lot there and I really hope that you can give some sort of input in it,
Thank You,
Gordon

[Gordo78]

The GP/ Spinal specialist has  suggested that they fuse 2 areas.  I am awaiting appointment with the surgeon as to when I can go for surgery, they said about 4 months away.  Unless I lose total control of my bladder, then they will do an emergency surgery.  I have lost some control of my bladder because of all this,
Yuk!
Gordon

[jelkins]

I had the Charite artificial disc replacement, about 5 yrs ago.  Previous to that, I had a herniated disc w/ annular tear.  I don't know if the 5mm herniation caused most of the pain or the annular tear.  Although, I have heard that the annular tear causes a lot of pain.  FYI...I have been VERY happy with the replacement.  Some recommend fusion.  I have heard that after a fusion, it can cause a "domino effect" - where the discs above & below are eventually compromised.  With the artificial disc, I can move in any direction, without restriction.

[Gordo78]

Thank you very much for very clear and understandable way to understand everything in the MRI.  I appreciate your findings and will post to keep you updated!
Thank you,
Gordon

[kittyluv1]

Welcome to the Back and Neck Community.  Members are here to provide assistance and support to individuals experiencing symptoms related to possible abnormal conditions of the cervical and/or lumbar spine.  Advice given is non-professional and is primarily based on personal experiences.

The MRI of your lumbar spine does show some significant findings.  Our spinal cord travels from our brain to the lower part of our body through the spinal canal.  The spinal column is the "backbone" of the skeleton and consists of multiple vertebrae with soft, pliable intervertebral discs which cushion our spine and help with movement.
Degenerative disc disease occurs as a matter of wear and tear as we age added to any congenital spinal conditions.  The intervertebral discs lose moisture and dry out becoming more brittle and increase the probability of protruding through their outer covering and creating structural changes in the spinal column and possible compression of the spinal nerve roots at these levels.
Your MRI shows multi-level degenerative changes, the most significant at L4-5 creating a severe degree of central spinal canal stenosis (narrowing) which decreases the space the spinal cord travels through.  The foraminal openings are the areas of the vertebrae that allow passage of the spinal nerve roots from the spinal cord to parts of the body.
At L4-5, there is some stenosis, but no evidence of nerve root compression.
L3-4 shows disc bulging as well as vertebral bone changes (facet hypertrophy) which is again causing stenosis of the spinal canal and indentation of the thecal sac which is the outer covering of the spinal cord.
L5-S1 has disc bulging and a tear in the annulus (protective covering of the intervertebral disc) and is pressing on the thecal sac at this level as well.  While there are vertebral changes at this level with mild stenosis, there is no definitive nerve root impingement or compression,
From these findings, it could be expected that you would be having low back pain and symptoms of pain, tingling and numbness of your leg and possible muscle weakness.
The referral to the neurosurgeon is appropriate and it is anticipated that he will discuss treatment options which would include discussion of a spinal fusion at L4-5 and L5-S1 due to the involvement of the spinal cord at these levels.  While the L3-4 level has some degenerative changes, it may not be necessary for a fusion at this level.
The objective of surgery is to remove compression of spinal nerve roots and compression of the spinal cord as soon as possible to prevent further neurological changes and the potential of permanent nerve damage that could not be repaired even with surgery.
It is important for you to obtain as much information as possible from the neurosurgeon about the anticipated outcome of the proposed surgery and the potential risk of electing not to have surgery at this time.  It is a very personal decision and should be based on the severity of your symptoms and the changes in your lifestyle that have occurred.
Please post back with the results of your consultation and with any additional questions/concerns you may have.
Best wishes -----