Help with MRI report

[ezracer1]

Have had a diskectomy 3/00 and a hemilaminectomy/diskectomy 9/04. I have been dealing with low back pain for the last few years and have been going to pain management for the past year. So far I have had 2 epidural and 2 facet joint injections and 1 radiofrequency treatment. Still hurting after all of that so Dr. ordered an MRI. Need some help understanding the following:
At L4-5, there is a moderate focal left paracentral protrusion with minimal caudal extension with mass effect on the left L5 nerve roots in the lateral resess, and mild central stenosis partial left hemilaminectomy. Mild/moderate facet hypertrophic spurring. This with enplate spurring causes mild/moderate bilateral neural foraminal stenosis. There is minimal enhancing scar in the sugical bed. Impression: Degenerative changes at L4-5. Moderate left paramedian protrusion with minimal caudal extension casuing mass effect on the L5 nerve root in the lateral recess, and mild central narrowing. Moderate bilateral neural foraminal stenosis.

Thanks in advance for any help!

 

[mznell]

In the most basic of terms, there are degenerative changes at the L4-5 level. It looks like your nerve root at L4-5 is competing for space as it tries to exit the L4-5 foramen. There is some bony overgrowth that is making the space in the central spinal canal more narrow than "normal." There is also the same problem at the foramenthe little "hole" where the nerve exits, leading in the main spinal cord) on both sides (bilateral). Part of this may be caused by scar tissue and part is from degenerative changes. The net result is the same: the nerve root is competing for space with these overgrowths as they pass through the foramen and the central spinal canal. The L5 nerve root is particularly effected by these issues and may be either inflamed or pinched, either of which can cause pain in your lower back and running down your leg.