I have recently completed an MRI and the findings puzzle me. What I NEED is a lay-persons's explaination AND a sober sound second opinion regarding treatment options.
On the localized scan mild disc bulges are noted in the cervical spine at the C5-C6 and C6-C7 levels.
Alignment of the lower thoracolumbar spine is maintained. A small Schmorl's node is present at the superior endplate of L3. Otherwise height and signal of the vertebral bodies is unremarkable.
There is minimal disk desiccation at L3-L4; L4-L5 and L5-S1 levels without loss of height.
Conus Modularise terminates posterior to the L1.
The L2-L3 level shows no disk bulge or protrusion,
The L3-L4 levels shows minimal bulging of the annulus in the left foraminal and far lateral locations. Mid-mild to moderate facet joint arthropathy and ligamentum flavum thickening are present. Mild neural foramina narrowing is present bilaterally without evidence of nerve root impingement.
The L4-L5 level shows a broad-based disk bulge extending from one paracentral location to the other. Moderate bilateral facet joint arthropathy and ligamentum flavum thickening is noted. Mild to moderate narrowing of the bilateral neural foramina. There is mild contact with the exiting bilateral L4 nerve roots. Please correlate for L4 radiculopathy. There is also mild lateral recess narrowing. Central canal remains patent.
The L5-S1 level shows mild to broad-based bulging of the annulus resulting in slight contact with the anterior thecal sac. Mild bilateral facet joint arthropathy is seen. Posterior vertebral marginal osteophyte is noted on the left side. There is mild to moderate narrowing of the left foramina and mild narrowing of the left foramina and mild narrowing of the right neutral foramina. There is contact with and possible mild compression of the exiting left L5 root as it courses through the neutral foramina.
What the heck does this diagnosis all mean.
The first thing out of my doctor’s mouth was that we should make an appointment with a neurosurgeon. Not that this is out of the question but I would prefer it to be an option and not the only consideration as a course of action.
Since this accident that caused this problem (fall on the ice December 2007) I have been through plenty of treatments ranging from Chiropractors (2 months) to Physiotherapy (4 months) along with massage therapy and have made substantial positive gains in my personal health related to pain management. The major symptoms I have these days are lower back pain (intermittent) numbness on the inside of my left foot (cold feeling and weakness at times as well) intermittent weakness in my left leg and stiffness if I don’t move about with regularity. Generally speaking the strong unbearable pains I had experienced (sciatica) have subsided to the point where there are many many more times when I don’t have pain verses having pain.
So, is surgery the only option I should consider! Unfortunately my doctor does not like to be questioned regarding their suggestions. As such I am treading carefully so as not to upset Doc and risk being removed from his patient list as a patient who will not follow their physician’s advise. (Canadian medical care system has too few family physicians).
So... I’m looking for some advice, some sound advise from those who have been where I am today.
Any thoughts or comments are welcome and taken in the spirit they are given