Opinion On My Mri (spondylolisthesis)

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

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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.