Opinion On My Mri (spondylolisthesis) Posted: 03-16-06 19:08pm
Hi all,
i'm doing as much research as is possible,
but would greatly appreciate any
feedback/opinions/suggestions etc.
A tiny bit of history. I'm 38.
Always been very athletic. Done a good
deal of weightlifting, and play
competetive table tennis. Overall very
good health. For years I have endured
lower back pain, usually after standing
for significant periods of time. It
seemed to bother me during the morning
hours, but once I had been up for a bit
things would loosen up and I would be
fine. 3 weeks back I woke one morning
and found myself unable to be on my feet
for more than about 5-8 minutes. The
pain is sciatic in nature...Runs down the
right buttock and leg.
I had an mri done and the results are
below. I am seeing a specialist in
about a week. I pretty much understand
what this report is telling me, but I am
curious as to whether or not this looks
like inevitable surgery.
Does anyone ever 'come back' from the
condition I am describing? I know that
a spondylolisthesis won't reverse itself,
but is the pain I am experiencing a case
where something (the nerve) is simply
swollen? Once the inflammation sunsides
perhaps the impingement will let up? Or
is this just a fool's wishful thinking?
From all of my reading is seems important
to exhaust all the more conservative
routes before marching into surgery. I
have purchased an inversion table after
finding a few studies that indicated it
could be beneficial. Again, some people
cry snake oil, but a few millimeters of
seperation might be the difference between
'ouch' and 'ouch!!!!'.
Regardless, here are my mri results.
Please tell me what you think. Destined
for the kinfe? Thank you all,
robert
---------------------
mri spine lumbar 3/4/2006
findings: there is a grade ii anterior
spondylolisthesis at l5/s1 measuring
approx. 15 mm. There is no listhesis
at the remaining levels. There is a
straightening of the normal lordosis.
There is no fracture. The conus
medullaris is unremarkable terminating at
the t12/l1 level. The t12/l1 through
the l3/4 disc levels are unremarkable.
At l4/5 there is mild disc dehydration
without disc space narrowing. There is
a small annular tear with small central
disc protrusion without spinal stenosis or
nerve impingement.
At l5/s1, there is severe degenerative
disc disease with severe disc space
narrowing, disc dehydration, and probably
vacuum disc change. There are
discogenic degenerative marrow signal
changes at the endplates. Grade ii
anterior spondylolisthesis appears to be
secondary to bilateral pars defects.
This produces distortion of the neural
foramina which have a more horizontal
orientation and are severely narrowed in
vertical height with significant
compression on the exiting l5 nerve roots
bilaterally. There are mild
hypertrophic changes of the facet joints
but without significant spinal canal
stenosis.
Impression:
1. L5/s1 grade ii anterior
spondylolisthesis secondary to bilateral
pars defects with sever degenerative disc
disease at this level. This combination
causes severe foraminal narrowing
bilaterally with impingement on the
exiting l5 nerve roots.
2. L4/5 mild degenerative disc disease
with small annular tear and central disc
protrusion without nerve impingement.
|
arunlnaik
New User, Becoming EHEALTHy
Joined: 17 Mar 2006 Posts: 11 Location: Bangalore
Here's the Solution Posted: 03-17-06 12:15pm
Hi
i read your report. It mentions of a pars
defect at l5-s1 level. That means your
spine at that level is 'fractured'. It is
potentially unstable at times specially
while playing sports, lifting weight etc.
You sooner or later have to decide for
surgery. It involves l5-s1 decompression
and pedicle screw fixation using a reputed
system like medtronic (titanium). You
should get significant relief of your
symptoms. But make sure you visit an
experienced neurosurgeon for your
procedure.
Bye and cheers
dr arun naik
|
Flying Poo
New User, Becoming EHEALTHy
Joined: 16 Mar 2006 Posts: 2
Posted: 03-17-06 12:34pm
Thanks for the reply. Is the procedure
you are referring to "l5-s1 decompression
and pedicle screw fixation" the same thing
as a fusion?
Appreciate all responses.
Robert
|
sandyallen
Extremely EHEALTHy
Joined: 02 Feb 2004 Posts: 4580
Posted: 03-17-06 13:41pm
Hi there! Sorry to hear of your negative
situation! My l4 and l5 to s1 comes and
goes, I understand your pain but I have
other medical problems too. After my two
neck fusions, I did not want any more and
my dr sort of agreed with me as he said
that a lot of times,especially in my
situation that one surgery will lead to
another and another , etc.(no thanks) and
I will be honest with you I am a little
bit afraid of them starting in with my
back as the poster said prior that I too
hope that you will get a good neuro and
also think of getting other opinions as
well, I am probably a lot older than you
and have ddd and djd(arthritis) along with
other things wrong.
I do wish you the best!
Let us know what you find out!
|
Tamadrummer
Active User, Really EHEALTHy
Joined: 15 Oct 2004 Posts: 710 Location: Zephyrhills,Fl
if the link does not work, you will need
to make sure that all of the letters in
the hyperlink are lower case. This site
capitalizes all letters after a period.
As far as making a full recovery without
intervention of somekind, I would be
hesitant to say yes. It is not
impossible but is very unlikly that this
will resolve on its own.
You need to be as well versed in the terms
and lingo the doctors/surgeons will be
telling you so that you can be an active
participant in the treatment plan for
you.
Most likly you will be asked to be
subjeted to steroid injections and
physical therapy. This will help the
doctors determine the necessity for
surgical intervention or not.
|
disabledcoastie
Experienced User , Rather EHEALTHy
Joined: 13 Dec 2005 Posts: 68 Location: West Virginia
Posted: 03-25-06 18:57pm
Sorry to about your results robert.
Unfortunately you are a canidate for
surgery and sooner or later you will
absolutely have to have the procedure
done. I would reccommend sooner as now
you have severe nerve root compression, if
the area isn't decompressed and fused you
could end up with nerve damage and when
that happens their is no relief. You can
come back after such a treatment and lead
a very normal life, you won't be doing and
world class dead lifts or anything but if
you work at your rehab you will be very
suprised at the results that can be
obtained. I would also suggest that you
not only have the pedicle procedure but
also cages added anteriorly as well. The
double fusion results in a stronger
fusion. One bit of advice listen to the
doctor's recommendation for lifestyle
changes, the reason I yelled this is that
most people (myself included) have to be
injured twice before we listen, i've had
two surgeries not doing so well now. Btw
my first surgery was to stabilize my
spondy, it was a huge success and if I
would have listened then I would be in the
shape I am now. Good luck