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What is the problem?

Posted By Bren on November 05, 1998 at 06:11:14:

I am 60 and have been on disability for almost 10 years.  I broke my left heel, arch and toes; tore plantar fascia and tendons left leg and crushed my tailbone in an accident. The pain is like a severe toothache from the hip, to the knee and down to the toes,  (Lots of pain around the knee, doctor calls it popliteus, I think). Sometimes it is red hot other times numb.  On really bad days, I can't lift my feet, but shuffle in a bent position.  I've seen 6 or 7 orthopedic surgeons and neurologists.  Also had epidurals, but didn't help. The doctors feel surgery is not the best plan. At the moment, am taking Elavil, Darvocet N100 or Tylenol and Codeine for pain and sleeping in a hospital bed.  I had a MRI recently and would like to know, in plain English, what it means.  Every time I see a new doctor they ask, what is your diagnosis?  I don't know.
Technique:  MRI was performed on the GE 1.5 Tesla Signa magnet.  Sagittal T1, sagittal FSE T2, axial FSE proton density and axial FSE T2 weighed images were performed.
The L3-4 disc space demonstrates a 2 mm diffuse disc bulge with associated moderate degenerative facet disease and hypertrophy ligamentum flavum.  No definite spinal stenosis.  The lateral recesses are normal.  The neural foramine are normal.
The L2-3 disc space demonstrates a 1-2 mm diffuse disc bulge with minimal impression upon the thecal sac.  The facet joints are normal.  Neural foramine are normal.  Lateral recesses are normal.  Sagittal images T11-12, T12-L1 and L1-2 demonstrate the disc spaces to be normal.  The conus is normal.  The neural foramine are normal.
S1-2 disc space is relatively well defined.  There is a partial transitional S1 vertebral body.  No disc herniation or disc bulge is seen.  The neural foramina appear normal.  No spinal stenosis is identified.
L5-S1 disc space is markedly narrowed.  There is a 2 mm posterior osteophyte and disc bulge identified.  There is moderately severe degenerative facet disease with some hypertrophy ligamentum flavum.  There is thecal sac compression posteriorally by the degenerative facet disease and hypertrophy ligamentum flavum.  There is no definite AP bony canal stenosis.  However, there is transverse canal narrowing at this level the significance of which is uncertain.
L4-5 disc space demonstrates a 3-4 mm diffuse disc bulge with associated degenerative facet disease and hypertrophy ligamentum flavum resulting in AP diameter of the spinal canal of 11 mm.  The thecal sac, however, at this level measures only 4 mm as opposed to 11 mm above and below the level consistent with severe spinal stenosis.
Sorry this is so long didn't know what could be left out.

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