SRS Anyone familar with lumbar MRIs and wants to speculate on the summary?

Offender

OT Supporter
Apr 6, 2002
15,449
Bergen County, NJ
I ended up in the ER 12/5 for unbearable sciatic pain. I've had back issues for years following a bad accident, tend to have 1-2 "episodes" a year, this one was out of nowhere and by far the worst. They gave me an awesome drug cocktail but it didn't do much unfortunately. Referred to a spinal surgeon who basically just referred to get the MRI done. I can't get a follow-up to review until next week.. so anyone familiar with these? Is there a chance it's a surgery situation? Steroids and painkillers and physical therapy? I've been mostly bedridden with my wedge pillow since, I just cannot get comfortable doing anything else even with my prescriptions (percocet, skelaxin, valium, gabapentin)

HISTORY: Right-sided sciatica, low back pain
TECHNIQUE: MRI of the lumbar spine without intravenous contrast.
FIELD STRENGTH: 1.5T
COMPARISON: None available.
FINDINGS: CURVATURE: Straightening of the lumbar spine is seen.
BONES/VERTEBRAL BODIES: No suspicious osseous lesion is present. Vertebral body heights are maintained. No compression deformity is present.
CONUS MEDULLARIS: Terminates normally. No compression or abnormal signal intensity of the lower thoracic cord or conus medullaris. Normal appearance of the cauda equina nerve roots.
SOFT TISSUES: No acute findings seen along the paraspinal soft tissues.
INTERVERTEBRAL DISCS/FACETS/ALIGNMENT: Multiple Schmorls nodes are seen. There is mild central congenital spinal stenosis.
- At L5-S1 mild diffuse bulge with moderate facet arthropathy seen. There is a large right lateral recess/central focal disc bulge which results in severe mass effect upon the right S1 nerve. Underlying disc bulge contributes to mild foraminal stenosis. There is mild central stenosis.
- At L4-5 mild disc bulge and moderate facet arthropathy results in mild central, lateral recess, andforaminal stenosis.
- At L3-4 mild disc bulge with moderate facet arthropathy results in mild central and moderate foraminalstenosis.
- At L2-3 there is moderate facet arthropathy without significant stenosis.

:hsd:
 
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whatever

OT Supporter
Feb 18, 2004
216,280
IIRC usually you pray like hell PT gets it manageable/extend life pre surgery. but its a ticking time bomb for a surgery.
 
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MWHC22

Bier/Deutsch/Homebrew/ Packers/Blackhawks/Outdoor
May 10, 2001
12,265
Wisconsin/Utah
I ended up in the ER 12/5 for unbearable sciatic pain. I've had back issues for years following a bad accident, tend to have 1-2 "episodes" a year, this one was out of nowhere and by far the worst. They gave me an awesome drug cocktail but it didn't do much unfortunately. Referred to a spinal surgeon who basically just referred to get the MRI done. I can't get a follow-up to review until next week.. so anyone familiar with these? Is there a chance it's a surgery situation? Steroids and painkillers and physical therapy? I've been mostly bedridden with my wedge pillow since, I just cannot get comfortable doing anything else even with my prescriptions (percocet, skelaxin, valium, gabapentin)

HISTORY: Right-sided sciatica, low back pain
TECHNIQUE: MRI of the lumbar spine without intravenous contrast.
FIELD STRENGTH: 1.5T
COMPARISON: None available.
FINDINGS: CURVATURE: Straightening of the lumbar spine is seen.
BONES/VERTEBRAL BODIES: No suspicious osseous lesion is present. Vertebral body heights are maintained. No compression deformity is present.
CONUS MEDULLARIS: Terminates normally. No compression or abnormal signal intensity of the lower thoracic cord or conus medullaris. Normal appearance of the cauda equina nerve roots.
SOFT TISSUES: No acute findings seen along the paraspinal soft tissues.
INTERVERTEBRAL DISCS/FACETS/ALIGNMENT: Multiple Schmorls nodes are seen. There is mild central congenital spinal stenosis.
- At L5-S1 mild diffuse bulge with moderate facet arthropathy seen. There is a large right lateral recess/central focal disc bulge which results in severe mass effect upon the right S1 nerve. Underlying disc bulge contributes to mild foraminal stenosis. There is mild central stenosis.
- At L4-5 mild disc bulge and moderate facet arthropathy results in mild central, lateral recess, andforaminal stenosis.
- At L3-4 mild disc bulge with moderate facet arthropathy results in mild central and moderate foraminalstenosis.
- At L2-3 there is moderate facet arthropathy without significant stenosis.

:hsd:
im still working with a lawyer from an accident 1.5 yrs ago that left me with pain and a cracked pars on a lower vertebrae. spine specialist/surgeon basically said you almost certainly won't heal back to 100% and that part of the body just doesn't heal well after you pass childhood. PT, some mild drugs I use as needed, a massage here and there, and mobility work is in my future for the rest of my life. its changed my life as i can't weightlift or do vigorous sports and activities without pain. im not sure what the going rate is for changing someones life but eventually my lawyer will let me know :hsd:
 

smithers

Twitter bot
OT Supporter
Nov 26, 2004
49,027
NJ/Chicago/Nashville
Respecting the SRS tag for a moment - if the summary report is to be trusted you have a disc herniation affecting just one level of your vertebral column and without any life threatening consequences like a cauda equine syndrome. If your symptoms match what is seen on radiology (back and leg pain worst on the right and radiating down the back of your leg and the lateral aspect of your toes), surgery could be warranted. There's no such thing as minor spine surgery but relatively speaking this is something not as complex that these days could be handled at an outpatient spine center. Hope you got a referral to the best spine surgeon in your area and try to schedule it before the end of the year when your deductible is already met :x:
 

Wolf

Slow Suicide's No Way To Go
OT Supporter
Mar 23, 2003
116,968
San Jose, CA
HISTORY: Right-sided sciatica, low back pain


:hsd:
Same. Starts at the center of my back at the beltline and goes all the way down the back of my right leg.
Most recent flare up appears to have been caused by my desk chair being too high. Over a couple weeks the nerve tingling started getting more and more noticeable until a couple weeks ago I went to pick up the cat's dish and pain went to 10. Luckily steroid and muscle relaxer did the trick after a few days. (prednisone, cyclobenzadrine)

But afterward realized that if I have my desk chair low to the floor, where my knees are higher than my hips, I have no pain.

Do you have adequate lumbar support when you sit? I went almost 18 months with bad pain due to an old La-Z-Boy I was sitting in every evening to watch TV.
 
TS
TS
Offender

Offender

OT Supporter
Apr 6, 2002
15,449
Bergen County, NJ
Respecting the SRS tag for a moment - if the summary report is to be trusted you have a disc herniation affecting just one level of your vertebral column and without any life threatening consequences like a cauda equine syndrome. If your symptoms match what is seen on radiology (back and leg pain worst on the right and radiating down the back of your leg and the lateral aspect of your toes), surgery could be warranted. There's no such thing as minor spine surgery but relatively speaking this is something not as complex that these days could be handled at an outpatient spine center. Hope you got a referral to the best spine surgeon in your area and try to schedule it before the end of the year when your deductible is already met :x:
:bigthumb:
I appreciate the insight.
SRS tag just to attempt keep it on point here, no worries. Rothman Institute, surgeon himself seems to be well experienced.
 

Scold

Well-Known Member
Nov 24, 2007
19,741
SJ,CA
I ended up in the ER 12/5 for unbearable sciatic pain. I've had back issues for years following a bad accident, tend to have 1-2 "episodes" a year, this one was out of nowhere and by far the worst. They gave me an awesome drug cocktail but it didn't do much unfortunately. Referred to a spinal surgeon who basically just referred to get the MRI done. I can't get a follow-up to review until next week.. so anyone familiar with these? Is there a chance it's a surgery situation? Steroids and painkillers and physical therapy? I've been mostly bedridden with my wedge pillow since, I just cannot get comfortable doing anything else even with my prescriptions (percocet, skelaxin, valium, gabapentin)

HISTORY: Right-sided sciatica, low back pain
TECHNIQUE: MRI of the lumbar spine without intravenous contrast.
FIELD STRENGTH: 1.5T
COMPARISON: None available.
FINDINGS: CURVATURE: Straightening of the lumbar spine is seen.
BONES/VERTEBRAL BODIES: No suspicious osseous lesion is present. Vertebral body heights are maintained. No compression deformity is present.
CONUS MEDULLARIS: Terminates normally. No compression or abnormal signal intensity of the lower thoracic cord or conus medullaris. Normal appearance of the cauda equina nerve roots.
SOFT TISSUES: No acute findings seen along the paraspinal soft tissues.
INTERVERTEBRAL DISCS/FACETS/ALIGNMENT: Multiple Schmorls nodes are seen. There is mild central congenital spinal stenosis.
- At L5-S1 mild diffuse bulge with moderate facet arthropathy seen. There is a large right lateral recess/central focal disc bulge which results in severe mass effect upon the right S1 nerve. Underlying disc bulge contributes to mild foraminal stenosis. There is mild central stenosis.
- At L4-5 mild disc bulge and moderate facet arthropathy results in mild central, lateral recess, andforaminal stenosis.
- At L3-4 mild disc bulge with moderate facet arthropathy results in mild central and moderate foraminalstenosis.
- At L2-3 there is moderate facet arthropathy without significant stenosis.

:hsd:
You’re gonna have physical therapy and at most an injection in the spine of some steroids. I had a 2cm herniation at L4-5 and that required a microdiscectomy. For a bulge, they’ll tell you to lose weight, always lift with your legs, improve your posture, and follow their physical therapy program.
 

Scold

Well-Known Member
Nov 24, 2007
19,741
SJ,CA
Respecting the SRS tag for a moment - if the summary report is to be trusted you have a disc herniation affecting just one level of your vertebral column and without any life threatening consequences like a cauda equine syndrome. If your symptoms match what is seen on radiology (back and leg pain worst on the right and radiating down the back of your leg and the lateral aspect of your toes), surgery could be warranted. There's no such thing as minor spine surgery but relatively speaking this is something not as complex that these days could be handled at an outpatient spine center. Hope you got a referral to the best spine surgeon in your area and try to schedule it before the end of the year when your deductible is already met :x:
Am I blind? I don’t see anything but bulges listed.
 

smithers

Twitter bot
OT Supporter
Nov 26, 2004
49,027
NJ/Chicago/Nashville
Am I blind? I don’t see anything but bulges listed.
You are exactly correct sorry I read the interpretation wrong - another reason why radiology is not to be interpreted by anyone other than the person deciding to operate on you :o The problem with low back pain is that ppl with herniated discs have no back pain at all, but ppl with bulging discs without overt evidence of herniation can have significant symptoms (likely what is going on here).
 

Scold

Well-Known Member
Nov 24, 2007
19,741
SJ,CA
Oh, and as someone who has life long cauda equina complications, if you experience ANY symptoms of cauda equina, get your ass to an ER.
 

Scold

Well-Known Member
Nov 24, 2007
19,741
SJ,CA
You are exactly correct sorry I read the interpretation wrong - another reason why radiology is not to be interpreted by anyone other than the person deciding to operate on you :o
I read it like 5 times after reading your post haha. I was like “I know I’m retarded but I don’t see what he’s talking about” :rofl:
 

Phlab

OT Supporter
May 2, 2004
36,729
NYC/Columbus
disclaimer: i'm not a doctor. i got hit by a car (as a pedestrian) and my back got pretty jacked up. what followed was years of deep-diving anatomy/PT + procedure options

my situation was mostly cervical, with some T and L spine mixed in

my MRI readout was similar to yours in extent (lots of "mild" and "moderate", bulges, stenosis)

similar symtpoms - couple of episodes where i'd need to excuse myself from dinner and go lay down on the parking lot floor :rofl:

for me, a few steroid jabs (timed a decent chunk apart) and learning how to maintain good posture and move in a non-idiotic/lazy way has me 99% back to baseline. this all took time.

PT helped too, but staying in good shape and being intentional about my posture was the big difference maker

you're gonna be fine dude. whatever you do, try to avoid surgery for as long as possible. i know the pain right now is probably hilariously bad, but if I can crawl my way back to normalcy with conservative therapy, there's a great chance you can too
 
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Phlab

OT Supporter
May 2, 2004
36,729
NYC/Columbus
also, if you do end up feeling better, make sure to stay active, in an intelligent way. staying active makes me feel 10x better.. if i'm ever on vacation or having a long lazy weekend, those slouchy couch potato days make me feel like trash

i still lift and move around a lot, but i don't fuck with heavy compound lifts that are ultra form-dependent, like squats and deadlifts. they're not bad for your back if you have -perfect- form, but guess how many people have -perfect- form? very, very few.
 
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Phlab

OT Supporter
May 2, 2004
36,729
NYC/Columbus
also was prescribed the works (skelaxin, other stuff in its ballpark, gabapentin (which gave me insane dreams), etc)

ultimately, nothing worked quite as well as 800mg ibuprofin a couple times a day, sustained for at least a few days in a row. with food obvi
 

Phlab

OT Supporter
May 2, 2004
36,729
NYC/Columbus
additional sidenote: don't get discouraged by trying to personally interpret any weird shit on your MRI. even plenty of completely healthy, uninjured backs have really funky MRI readouts and disc issues -- it's just that most cases are asymptomatic
 

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