MRI Lumbar Spine

[nrseprn41]

I have had a cascade of problems starting almost 4 years ago.  I have numbness in both feet  ( peripheral neuropathy, idiopathic I am told ) horrible feet and legs spasms, and chronic leg pain.  I have also been diagnosed with erythromelalgia which makes it impossible for me to walk or tolerate temperatures over about 70 degrees.  My feet are always bright red and swollen. I feel like my legs are spaghetti sometimes.  They have ruled everything out from Lupus to MS. I have RLS which starts about 3pm every day and makes sleeping impossible.   I am a national champion speedskater and have always been athletic and active.  I have had to stop my running and am lucky to be able to walk the dog.   Lately I feel like I always have a UTI but my test is negative. My pain radiates down both buttocks and legs.  I get sharp pains in my feet and legs at times and have occasional parathesis.    

Finally a lumbar MRI was done

Bilateral L5 spondylolysis with Grade-1 anterolisthesis of L5 on  
S1.  Vertebral body heights well maintained.  Disc desiccation L4-5 and L5-S1  
with mild disc space narrowing L4-5. The conus tip at the L1 level and normal  
in signal.  No abnormal enhancement.

L1-2: No central canal or foraminal narrowing.

L2-3: No central canal or foraminal narrowing.

L3-4: Mild facet degenerative changes without central canal or foraminal  
narrowing.

L4-5: Severe facet degenerative changes, circumferential disc bulge results  
in moderate bilateral foraminal narrowing.   No significant canal stenosis.

L5-S1: Bilateral L5 spondylolysis with moderate facet degenerative changes  
and Grade-1 anterolisthesis.  Mild dorsal disc bulge contributes to mild  
bilateral foraminal narrowing.  

Bilateral L5 spondylolysis with Grade-1 anterolisthesis of L5 on S1  
contributing to mild bilateral foraminal narrowing at L5-S1.

Moderate bilateral foraminal narrowing L4-5.

Any insight would be appreciated. Next MD appt not for 2 months

Sharon

[Abhijeet Ghosh]

Dear Sharon,
As per the description, the problem appears to be a bit related to the anterolisthesis and the formainal narrowing.
Anterolisthesis means that the allignment of the 2 bones (L5-S1) has been lost and the S-1 has moved forwards, as compared to it's normal anatomical position.
Foraminal Narrowing means that the foramen ( outlets of the spinal nerves) have been narrowed, due to which the nerves are getting compressed.
Due to this, the normal transmission of nerve impluse is getting affected and is evident by the symptoms, which you are facing presently.
Degeneration is due to the result of overuse of the back muscles, due to the athletic activities you had done in the past.

Since the next appointment is due after 2 months, request you to consult a good physiotherapist presently, and learn to do some spinal stabilization physiotherapy, for the strengthening of the spinal muscles, due to which, the muscles would be able to sustain the pressure created by the arthritis and listhesis, for a longer duration.

Please discuss, for further clarification

[Irma2011]

A related discussion, issue with my neck/spine was started.

[nrseprn41]

I was not willing to wait for 2 months as I already have so much neuro symptoms.  I have seen 3 Dr's of which all think due to my symptoms and the L5 spondylolysis bilaterally that surgery might be indicated.  I am very hesitant to make this decision as of yet.  My worry is that I am afraid my neruological pain and symptoms will only get worse and what is already there is probably not reversible.  I have recently already had bladder and bowel problems.  

Do you think waiting would be beneficial or might my problems might just keep getting worse.  I have been doing PT and am not overweight.  

Thanks
Sharon
Sharon