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new mri results, would like some advice

AnonymousUserAAnonymousUser Posts: 49,671
Hello everyone, I just got my mri results thurday, and my dr would like me to see a surgeon. Anyways I would like some advice and some input on the results.

There is evidence for a posterior annular tear with a high intensity zone at L4/L5. Ther is a borderline spinal canal stenosis due to a combination of a small amount of disc material, ligamentous thickening and bony hypertrophic changes. Moderat compromise of the left and right lateral recesses, as well as mild neural foraminal encroachment bilaterally.
Evidenc for a posterior annular tear with a high intensit zone at L5/S1. There is a underlying bulge 3mm. The neural foamina appear mildly to moderately encroached. It could result in L5 radicular type symptoms.
The rest of the lumbar is normal, thank god.

Anyways what is a annular tear? Does there seem to be anyway to avoid surgery? I've been doing a ton of exercises and my muscles are built back up. I'm not up for golf and all the other fun stuff. I manage to work allday but I am limited. My pain lvl is a 3 most of the time compared to 8-10 24/7. I thought I was getting better untill this mri knocked the wind out of my sails. My main issue is my feet and hamstring my back does'nt hurt to often.

Well any input would be greatly appreciated, thanks


  • Hi ya,

    not a doc... i found this on the web and after reading it I think "annular" is referring to the outer layer of the disc which anatomically is called the "annulus fibrosis"... so in english??? I think its referring to a herniation of the disc:

    "This process occurs when the inner core (nucleus pulposus) of the intervertebral disc bulges out through the outer layer of ligaments that surround the disc (annulus fibrosis). " I found it at the following link:


    hope that helps!
    L4-L5 fusion 1998; ACDF C4-6 2008; DDD
  • Sounds like you have some disc material that is leaking out from the interior of the disc, due to the tear. This, along with the slight bulging of the L5-S1 disc is taking up space where the spinal nerves need to pass freely. It is this compression that is most likely causing the sciatic pain symptoms you are feeling in your leg.

    It is possible for a herniated disc to heal on its own, but it will require a great deal of patience. You can generally get past the acute phase in 6-8 weeks, but it will take at least 6 months for the disc to heal. During this time you will need to be very vigilant with the use of your back. You will need to avoid any activities that involve bending or twisting and should avoid lifting anything heavier than about 10 pounds. It is espcially important that you do not lift AND twist at the same time!

    You would probably benefit from going to a physical therapist that has a spine-oriented practice to learn appropriate exercises to strengthen and balance the muscles and soft tissues that support the spine.

    Surgery only becomes necessary if you develop bowel or bladder involvement (read up on "cauda equina syndrome")or the pain is such that you cannot tolerate it. Most people end up having surgery for a ruptured disc because they cannot tolerate the pain and surgery seems like a good solution (or a faster fix). Most people do not have the patience that is required to heal on their own.

    Walking is the best exercise for you while you are healing...on a level surface, and preferably not on a treadmill. You can apply ice or heat(whichever you find more soothing) on your lower back to help with pain relief.
    You want to get the inflammation to go down so there is less compression on the nerve.

    Whatever doctor you choose to see, be sure she/he is fellowship-trained in spinal surgery. If you are dead set against surgery, you might want to consult with a physiatrist ("Physiatry – also called physical medicine and rehabilitation – is a branch of medicine that specializes in diagnosis, treatment and management of disease primarily using "physical" means (such as physical therapy and medications). Essentially, physiatrists specialize in a wide variety of conservative treatments for the musculoskeletal system (the muscles and bones) and do not perform surgery." --from Spine-Health). You can find physiatrists that specialize in issues of the spine and back.

    Ask lots of questions and become as informed as you can. Do not agree to surgery without exploring all options and getting several opinions. Hopefully your issues will resolve in the near future, and you won't need surgery.
  • back surgeries at all cost! then do ..as i person that has had 2 back surgeries and is now unable to move of his recliner and is in pain all the time .. if you can sleep /work without too much interference in your life then run like hell ...away from surgery...good luck
  • I met with the surgeon last last week, I was told he was very conservative. He did'nt offer me anything but surgery he said the only way to fix me was a bilateral laminectomy. I asked about a shot in the back and he said it would'nt do any good. I found out today he wants me to go in april 1 and everythings set up.

    I would like to get a second opinion , and see if theres anyway possible to avoid getting cut. And if I have to I would like to do it in June. I need to get some things in order.

    Has anyone had this type of surgery? How long are you down? Can you function close to normal afterward? What can I do to make recovery faster? Will I be able to do my job? Golf all the fun stuff? Man this is scary.

    Thanks for any advice

  • Yes, many people have had this surgery. If you run a search for "laminectomy" you can read many experiences with this procedure.

    It is always a good idea to get several opinions, as surgery can be a life-changing event. Be sure you look for a fellowship-trained spinal specialist. This could be either an orthopedic surgeon who devotes his practice to issues of the back and spine, or a neurosurgeon. The fellowship means the physician has additional, specialized training in the spine and that is what he spends his life working on.

    Some conditions cannot be effectively treated except with surgery. Perhaps that is your situation. You don't mention what is your diagnosis. Often a herniated disc will heal on its own, but there are cases where a nerve is so compressed that surgery is required to prevent permanent damage.

    Depending on your surgery, many people are back to work in two to three weeks after a laminectomy --there are many variables, like what your job entails, how complicated the surgery is, how your body heals, etc. Unfortunately, there is no way to predict how an individual will heal.

    If you have this surgery, you should not think about rushing the recovery. This is where most people get into trouble...leading often to a reherniation of the disc. If you can be patient at the beginning and let your body fully recover, chances are good that you can return to your life as you now know it.

    Do remember that most back surgeries are elective. You are in the driver's seat. Do not let anyone rush you into it. There are a few cases where back surgery is considered an emergency and must be done immediately, but from your post, it does not sound like you fit into that category. Get at least another opinion from a surgeon in a different practice. Take your time and schedule things the way you want them. If you are set against surgery, I suggest you go to a physiatrist that specializes in orthopedic cases. This is a doctor who will do everything to help you get back to your regular life...everything short of surgery.
  • i have it at S1 on Nov 07 since the operation i have had more pain in the back {not as much in the leg }and i have been weak since the operation.its a big operation ans it will take you a long time to recover to a level that the medical world are OK with..you may never recover to a level where you are happy though! {like me} i have been told that this is it make the best it wont get any better!}so good luck mt friend
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