Need Help with MRI Results for lower back

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pinkfunpolice

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Hello,

I am looking for help interpreting my MRI results. I am 45 and have had back pain since I was a teen. I recently went to an orthopedist and had an MRI. He told me I have arthritis, but my internist (who ordered the MRI) said I don't. I have pain most days, but I am really worried about my future if I am like this at my age now.

MRI Lurabar Spine:

There is narrowing and desiccation of the L4-5 disc, with associated degenerative marrow change. The conus appears normal.

There is slight facet hypertrophy at L2-3.

At L3-4, there is mild diffuse disc bulge with a partial annular tear. There is minimal truncation of the proximal L4 lateral recesses, left greater than right. There is mild facet hypertrophy.

At L4-5, there is annular bulge with mild to moderate spinal stenosis. There is narrowing of the proximal L5 lateral recesses, right greater than left. There is moderate to severe facet hypertrophy.

At L5-S1, there is moderate to severe facet hypertrophy.

Impression: Facet arthrosis at L4-S1, with relatively minor spinal stenosis at L4-5. Annular bulge at L3-5.

Any help would be appreciated. Thanks.
 
Hi. I hope I can help you out a little bit. Your ortho is closer to being right, but you have more than arthritis going on.

You have one disc (L3-4) that has a tear in it and it is bulging. At the next level down (l4-5) the disc is also bulging and putting some pressure on the opening where the nerves are (stenosis).

I am curious as to what your symptoms are. Are you having low back pain, leg pain, a corabination?

I would suggest that since both doctors were either wrong or not forthcoming (you do have some mild arthritis), you should find yourself a spine specialist...either a neurosurgeon or an Orthopedic Spine Specialist. That is an ortho who works only on the spine and limits his practice to that area only and will have a fellowship. Tho they are both surgeons, it doesn't mean you need surgery, especially at this point. However, it does mean that you will be under the care of a doctor who is most knowledgeable about your problems and who will best know how to treat them. Some of those things might be physical therapy, injections, or other procedures. Do not let any doctor rush you into surgery but if it is pushed, be sure to get at least one more opinion, if not more. You can always have the surgery but you can't go back once it is done! The exception is if nerves are compromised to the point that the damage becomes permanent.

I wish the best to you and hope you find a good, caring, competent dr. who will listen carefully to you. Don't settle for less!

Carol
 
Carol,

Thanks so much for your reply. I do have pain and sensations that shoot to my hips and down my legs. They are achy feeling, but not horrible. As I said, I have had pain in my back for a long time. I have gone to chiropractors in the past. When I get acute exacerbations, I have been put on muscle relaxants and anti inflammatories. Unfortunately, my father has also had a bad back most of his life and had surgery around 8 years ago. I am concerned because I am finding that in the last year and a half, I have had to curtail my activities due to my back.

The orthopedist did tell me about the disc bulges and the spinal stenosis also. I was mainly just confused about the arthritis part. Thanks for the suggestion about going to a back specialist. I know that there is one in the practice I went to. I guess I can ask to see him.

Thanks for the help!

Karen
 
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