Lumbar MRI results: my sister could use some help understanding her report; doesn't see doc for quite a while..

[Fluffysmom]

My sister sent me the results of her lumbar MRI, wanting my help since I've had so many of the doggone things.  I've had a hard time focusing on it and writing her a comprehensive answer (I have MS and having trouble with fatigue, blurred vision, etc).  I'll post what she sent and see if anyone can help me come up with some information for her.

Thank you:

Impression:
1. Large left paracentral disk extrusion at L5-S1 causing severe
left lateral recess narrowing and moderate spinal canal narrowing.
This disk is displacing the S1 nerve root and contacts the S2 nerve
in the thecal sac.

2. Multilevel additional degenerative disk disease and facet
arthropathy, most prominent at L4-5 which is causing mild spinal
canal narrowing, bilateral moderate lateral recess narrowing, and
mild right neural foraminal narrowing.

3. Hyperintense T2/STIR signal in the left paraspinal musculature
can be seen with early denervation atrophy.
----------

Findings: Two small hemangiomas are noted in the L2 vertebral body.
There are several scattered small Schmorl's nodes at T11-12, T12-L1,
L1-2, and L3-4. There is mild anterolisthesis at L4-5. The marrow
signal is otherwise normal. The conus demonstrates normal morphology
and terminates at T12. There is mildly hyperintense T2/STIR signal
in the left-sided paraspinal musculature from T12 through the sacrum.

L1-2: The spinal canal and neuroforamina are patent. There is mild
facet arthropathy. A small Schmorl's node is present.

L2-3: There is a small Schmorl's node. There is a small posterior
disk bulge without spinal canal or neural foraminal narrowing.

L3-4: There is a small Schmorl's node. There is mild disk space
narrowing and disk desiccation with a small posterior disk bulge,
mild laxity of the ligamentum flavum, and mild to moderate facet
arthropathy. The spinal canal is patent. There is mild bilateral
neural foraminal narrowing.

L4-5: There is mild anterolisthesis, moderate disk space narrowing, a
circumferential disk bulge, and moderate to severe facet arthropathy
causing mild spinal canal narrowing, moderate bilateral lateral
recess narrowing, and mild right neural foraminal narrowing.

L5-S1: There is mild disk space narrowing. There is a large
posterior disk extrusion filling approximately one half of the spinal
canal causing moderate spinal canal narrowing and severe left lateral
recess narrowing. The extrusion crosses midline to the right and
extends 6 mm above the inferior endplate of L5. It appears that the
L5 nerve root exits above and lateral to the large disk extrusion.
There is marked displacement of the S1 nerve root. The disk he
should also contacts the S2 nerve root in the thecal sac. The
neuroforamina are patent.

My eyes are blurring just looking to see if I got it all cut and pasted.  Thanks again for any input you might have.

[Fluffysmom]

Thank you for your comments.

I know that my sister has done a lot of physical therapy already.  She has been in a horrible amount of pain, which is also compounded by a hip labral tear.  She has worked very hard to be more active and lose weight so she could have the hip labral repair done and be able to rehab from that surgery well.  I think that pain has interfered wih that goal, though she has lost weight.

I hope that she will be a neurologist that wil be able to competently evaluate her condition and come up with the proper course of treatment.

I will pass along your comments to her; thank you so much for your valuable input.

[Dr. A. Srivastava]

Thank you for your question. Although without being able to placing her findings in context with clinical features and the results of other investigation such as hematological, MRI, I can not offer the specific advice & treatment you need. However, I will try to provide you some relevant information about your health concern.

I think that some spinal nerves (lumbar region) may be compressing in spine by disc prolapse & degeneration or stenosis. By the reason of that nerves from the spinal cord can be irritated causing weakness in the leg, leg/thigh pain and numbness, tingling. Few persons also face generalized body weakness and numbness due to other nerve irritation on back. If she suffers continuous weakness and notice reduced strength of muscle bulk in both the legs, please arrange an appointment with a neurologist right away who will evaluate the possibilities here. These “red flags” could be indicative of compression of the spinal cord and its nerve branches and early treatment is essential if permanent damage needs to be avoided. Further referral to a physiotherapist for spinal exercises could be beneficial and may produce relief of symptoms. Hope this helps.

Take Care & Stay Healthy!!!