Do I need surgery? Lower back

[Njen123]

hello

I've been having problems with my lower back for a few years now.  I've tried massage,Pt, Heat. and cortisone injection.  The injection did not work i felt more compressed.

My Mri reads:  L4-L5 shows degeneration of the disc with loss of T2 disc signal and mild disc space narrowing and bulge of the disc.  There is a high signal of the annulus in the right foramen, defining and annular tear.  Facet hypertrophy contributes to moderate canal stenosis. The neural foramina are mild to moderately narrowed, but there is no displacement of the existing nerve roots.

Impression:
MRI imaging of the lumbar spine demonstrating mild degeneration of L4- L5 disc with bulge of the disc and a right neural foraminal annular tear.  There is mild to moderate foraminal compromise bilaterally and moderate canal stenosis

at L5 - S1, Mild facet arthrosis is evident with small osteophytes.  No disc prodrusion, canal stenosis or nerve root compromise.

Also, can someone help me understand this -  it says Incidental note is made of dural ectasia in the sacal segments, I have researched this and kept comming up with Marfan syndrom - I do not fit the criterior for Marfans.

My questions is if i need surgery or would benefit form a sergical procedure based on my MRI report.  And, what type of surgery? or any other suggestion that might be helpful

Also, Can some have dural ectasia without having any connective tissue disorder?  can this be a cause of truma to the back?

Thanks for any advice you can provide......I'm 40 yrs old - average weight

[cat9841]

I luv kittys too.
hey I had a spinal fusion a year ago and it did help me a lot. but I read horror stories on this board. you have to follow your own drs advice. I think you should talk to your own dr and follow his/her advice per your own case, everyone and every case is different. please take care.
CAT

[cat9841]

I luv kittys too.
hey I had a spinal fusion a year ago and it did help me a lot. but I read horror stories on this board. you have to follow your own drs advice. I think you should talk to your own dr and follow his/her advice per your own case, everyone and every case is different. please take care.
CAT

[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 spine.  Advice given is non-professional and is primarily based on personal experiences.

Your MRI taken last year does show some mild compression of the L5 nerve root secondary to disc degeneration and facet joint (bony structure connecting two adjacent vertebrae) degeneration.  DDD (degenerative disc disease) occurs through the wear and tear of the spine as we age.  The only nerve involvement appears on this MRI at the L4-5 level.
DDD is a progressive process and there could have been interval changes that have occurred since your last MRI.  Another MRI might be needed to determine if your increased symptoms are related to additional degenerative changes.
Make an appt with your orthopedic specialist (or primary care physician if a referral to a specialist is required) for a clinical exam and additional diagnostic testing as needed/
Based on the clinical findings, treatment options can be discussed in further detail.
Failure of the conservative treatment you have done so far may not necessarily indicate the need for surgery.  Surgery is indicated primarily in cases of significant nerve involvement where disc degeneration, stenosis (narrowing of the spinal canal) and possible disc herniation exists. Symptoms of sciatica as well as any other neurological symptoms (loss of bladder control, etc) would need to be evaluated.
Please post again with your progress and with any additional questions/concerns you may have.
Best wishes ----

[akym]

hi, my name is ann, I had an mri done last yr, due to sciatica & lower back pain. is surgery necessary? hv been to PT, Chiro, Remedial Massage & Acupuncture, none works and pain is getting severe.

L3/4 - Mild broadbased disc bulge without significant neural impingement

L4/5 - Mild asymmetric broadbased disc bulge which is more prominent to the right of midline, in combination with facet joing degenerative change results in contact and probable compression of both surfaces of the traversing right L5 nerve root within the subarticular recess.

CONCLUSION
There is at least mild compression of the traversing right L5 nerve root of the L4/5 subarticular recess due to disc and severe facet joint degenerative change. No neural impingement is demonstrated otherise.