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MRI spine results

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There is disc dehydration within L3-4, L4-5 and L5-S1 with dorsobilateral bulging disc at L4-5 and L3-4 level with no involvement of left-right lateral recess. Dorsobilateral left disc protrusion at L5-S1 level with indentation to the left exiting nerve root together with facet arthropathy. The bone marrow shows no evidence of signal alterations despite chronic vertebral endplate/bone marrow changes at L5-S1 indicating fat replacement changes.
I understand individual parts but I am not seeing a specialist until sept so would be grateful of the general prognosis as a whole, thanks
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replied July 31st, 2011
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tillydog,

Unfortunately, prognosis depends greatly upon what your symptoms are and what your physical exam shows. Just because you have certain findings on a study, it does not necessarily mean that you may be having problems associated with them.

You have degenerative changes in both the discs and in the posterior facet joints. Some patients have back pain associated with these findings, while in others, it is an incidental finding. The same is true with the pressure on the nerve at the L5S1 disc. Do you have symptoms in your left lower extremity?

As to a prognosis, whether these findings are going to get better or worse, is of course, always the difficult part. Degenerative changes are not going to reverse themselves, with the tissues becoming young again. But, will they get worse? That is usually based on how fast your symptoms have developed and if you have any family history of the same problems.

That is why it is so important to correlate any findings on a study with the patient's history and physical exam, and for the patient to sit down an go over the study with his/her surgeon. Unfortunately, findings on their own are difficult to interpret.

Hope you are doing okay. Good luck.
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replied July 31st, 2011
I first had low back pain twenty years ago after having twins using epidural fir pain relief ( this was complete spinal block) I had x rays which showed slipped disc in L5 after various tablet firm pain relief I had a course of 3 sclerosant injections which relieved my pain and symptoms greatly, this was around 12 years ago . Around 6 years ago my symptoms and pain started to increase again and I have started from scratch with tablets form mess to phsio and referral to pain clinic. Lastly this Mri was undertaken and this us where I am yo date . I have extreme morning stiffness and limited mobility( doubled over) when I first get up which after maybe a couple of hours loosens. I sleep with difficulty and alternate from side to side. No tablets have any effect, I work full time but I have diufivulty remembering a time without pain, hoovering mopping sweeping is impossible. Reaching seems to be the biggest issue. Going from sitting to standing and standing to sitting can result in a back spasm. I have left and right back pain across the whole core area I don't feel safe my back feels weak and vulnerable. I have leg cramps pins and needles in both legs each day and disturbs my sleep . Dead aching legs (both) any insight would be welcome
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replied July 31st, 2011
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tillydog,

Well, you do have degenerative changes in your spine which could account for your morning stiffness and pain. The fact that it is worse in the morning and gets a little better with activity, is a classic hallmark for inflammation. This is usually treated with some type of antiinflammatory medication (NSAIDs, steroid, oral, injected, etc)

The pins and needles in the legs, if they are in a particular dermatome, that correlates with the nerve root being pressed upon, then that may be the beginning of a radiculopathy. A radiculopathy can cause numbness and tingling, pain, weakness, etc in the area supplied by a particular nerve root.

This has to be determined with a physical exam, to see if the area of symptoms is the same as the area supplied by that nerve.


So, you do have changes in the spine that could be causing your symptoms. Most are degenerative in nature, but, as to whether or not they will get worse, is hard to tell. They most likely will not get better on their own, but there are treatments for them.

So, make a list of questions you want your surgeon to answer. Because, he/she is the one who will have access to your studies and physical exam, and will be in the best position to answer those questions and discuss your treatment options.

Good luck.
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replied July 31st, 2011
Thank you for the advice I will make a list. Take care
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