Back Pain Forum - Help With Mri Results of Lower Back And F/u Opinion

First I’ve had lower back pain off and on for the past 5 years. A couple weeks ago I awoke at 4am with severe pain in my lower back, radiating down my left buttock, left leg and foot. I went to the E.R and was given an X-Ray. The E.R doc said I had a bulging disk in my lower back. The doc said “Everyone has a bulging disk, just right now, yours is really bulged”. I was given a shot of tordol(sp), a couple valium right there. I was also given a perscription for oxycodone w/apap 5/325 and Diazepam 10mg and told to follow up with the military hospital. Since this day, the littler toes on my left foot are numb, I have a burning sensation on the left side of my foot and back of my ankle. My left leg feels “lighter” than my right leg and just doesn’t seem to respond as fast .

The military Physicians Assistant(PA) scheduled a lower back T/L MRI for me at our local civilian hospital. 5 days later the MRI was done. The radiologist report states:

Findings: Composite images show some straightening of the usual lordosis. There is an anomalous L5-S1 level with sacralization of the L5 vertebra. This correlates with the plain-film acquisition of 7/22/07 showing the small vistigal T12 ribs.

Vertebral body heights, appearance, and signal are preserved, allowing for multiple Schmorl’s node deformities seen on the superior and inferior T12 endplate and the inferior L2 endplate. These generally are of no clinical significance.

Vertebral body height, appearance, and signal are preserved with no marrow edema, hemorrhage, and/or edema.

Conus is seen at about the T12-L1 level and shows no mass effect and/or abnormal signal in this uncontrasted study.

Disk spaces demonstrate the L1-L2 level and above to be essentially of normal height, appearance, and signal without herniation apparent.

The L2-L3 level is of normal height, appearance, and signal.

The L3-L4 level demonstrates normal height and signal without herniation of the disk evident.

The L4-L5 level shows diminished height and signal. There is a broad-based annular bulge into the left anterolateral canal and neural foramen consistent with L4 nerve root entrapment. A small fragment extends inferiorly into the left lateral recess, entrapping the thecal sac and L5 nerve root.

The L5-S1 level shows essentially no disk material to be present.

Conclusion: L4-L5 disk herniation to the left of midline with a fragment extending into the left lateral recess.

After my MRI results came back, I was referred to a military Orthopedic Surgeon to discuss my options. Instead of the surgeon, I met with a Physicians Assistant that didn’t even read my medical records and I had to practically force him to look at the MRI results the civilian hospital had put on a Computer Disk. While speaking with the PA I was asked how long until I was to retire from the Armed Services and questions that I didn’t think had any bearing on my current situation. The PA mentioned that radiologists don’t really know what they are looking at which left me wondering why they even look at them to begin with. He then left the room to review my MRI images, then came back 15 minutes later . He said that the reason I have numb toes and the other symptoms was the disk material was pushing against my nerve and “irritating it”, not really compressing it. A friend of mine told me that the longer a nerve is pinched there was a less chance of me getting feeling back. I asked the PA if this was true and he stated that the numbness and pain would never go away, and I’d hopefully just “get used to it” and even if they did operate on me, it wouldn’t stop the numbness and burning sensations in my foot and leg. We would have to take a “ wait and see” approach and was told to come back in 6 weeks. I was prescribed motrin, steriod injections in my lower back and physical therapy. No prolonged standing, sitting, running for 2 weeks.

My gut feeling is, I should get a second opinion. I just wanted to throw this out there and see what any of you have to say. I apologize for the long post, I am in pain, feeling hopeless at the moment and would like to see what others might have to say.

Thank you for your assistance.