My father 85 has been experiencing back pain a year.He is now bed ridden.He has been undergoing pain mgt treatment for more than 5 mos.Initially w/ some success but now is unable to walk or sit up 4 more than a few minutes.He underwent two surgeries 15+ years ago one for an abdominal aortal aneurism and a triple bypass.The following are abr. findings and impressions from the MRI 6/21/07
Findings*Endplate degenerative changes are seen at L4-L5 and L5-S1. Lumbar discs are desiccated with mod narrowing at L4-L5 and L5-S1. Mild anterior spondylosis is also noted at all lumbar levels.*At L3-L4, mild focal spondylostenosis id due to broad-based circumferential bulging of the disc with ligamentum flavum hypertrophy and mild facet hypertophic changes.There appears to be a tiny 2-3-mm synovial cyst associated with the left facet projecting torwards the paraspinal musculature. *At L4-L5, there is moderate focal spondylstenosis due to broad-based circumferential bulging of the disc with superimposed left pararcentral and posterolateral disc herniation extending into the entrance of the left neural foramen * A mod. degree of ligamentum flavum hypertrophy also results in mod. circumferential compression of the thecal sac and most pronounced anteriorly the left, likely impinging upon the intraspinal left L5 nerve root. The herniated disc measures approximately 8 mm from the posterior margin of the annulus. Bulging disc with facet spurring does result in mild to moderate left foraminal narrowing, and there is mild right foraminal narrowing with impingement upon the foraminal left L4 nerve root.At L5-S1, broad-based bulging of the disc superimposed on the transverse spondylotic ridge extends into the foramina. Facet hypertrophic changes contribute to marked right foraminal narrowing and moderate left foraminal narrowing with impingement upon the foraminal L5 nerve roots.Next steps?