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MRI Results

MollyFiveMMollyFive Posts: 7
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery
As some of you may know, I had my MRI last Friday. I have had severe pain since last June, however, since then I have been getting better very slowly. The appointment with the neurosurgeon was scheduled for next Tuesday but his office called today and said he wants to see me tomorrow to discuss surgery.

The results are:

A massive L4/5 disc protrusion is present, posterior and slightly asymmetric to the right. This results in marked compression of the thecal sac, to 3mm in AP dimension.

A small posterior annular tear is noted in the L5/S1 disc with a tiny central disc protrusion. No associated stenosis.

Remainder of lumbar discs are normal.

IMPRESSION: Massive L4/5 disc protrusion.

Just wondering if there are any thoughts on waiting to see if I get better on my own or is surgery the only answer. And if surgery is required, any thoughts on what the surgery will be? Has anyone had this type of back problem, and if so, what was done?

Are there any questions I should be asking the neurosurgeon?



  • If you're starting to show some improvement with out surgical intervention, I would take it slow for now and see how it goes. The surgeon doesn't make any money if you wait. Sometimes these problems can resolve on their own. It takes a little longer but might be better for you in the long run.

  • bothering you much, I'd stay away from the surgery. Some of these issues do resolve themselves. Sometimes disc matter that has been squished out sort of dries up and goes away. If it's pressing on nerves and making things really painful, you'd want to treat it, but if it's bearable, why let someone cut you?


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • How did you get hurt?
    On a 1-10 scale, rate your pain.
    Where is your pain?

    A small procedure could address the herniations.

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I have had on and off back pain for about 18 years. I am 42 now and the last "attack" I had was in 2005 when the MRI showed a herniation on L4/5. I got better on my own. This latest time we moved in June and I over did it - carrying heavy items, bending and twisting. When I sit I have no pain or very little on the outside of my knees, the right being worse than the left side. When I try to sleep I have severe pain, throbbing in my back and I have to get up. I have sciatica that runs down both legs into the tops of my feet, and I twitch or wiggle for about 20-30 minutes, it stops and then I try to sleep again. I only take OTC meds at night. The most I sleep is about 4 hours in a row. Walking is a big problem as well as standing. The pain then is about an 8 or 9. When I sit it is a 1 or 2 at most.
  • I also agree about maybe not jumping into surgery too quickly IF possible, depending on what your doctor says tomorrow since we don't know all the details. From what you say, the pain is really bad and it is impeding on your quality of life. I'm surprised you're still on OTC meds. I think the doctor might want to operate because of the size of the herniation and he also is probably concerned about the severity of the nerve compression. You don't want to wind up with permanent nerve damage because you put off surgery for too long. Only your doctor can assess your risk for that. They can also try a series of epidural injections if they feel you can put off surgery for a while. You do have the choice of getting a second opinion if your doctor wants you to consider having surgery, and in this way you know how best to proceed.

    Usually with a disc herniation they will have you try conservative treatments such as epidural injections, PT, rest, medications, maybe massage, acupuncture, aquatherapy, and have you try out a TENS unit.

    The only time you cannot put off surgery is when you show signs of Cauda Equina Syndrome and you can't control your bladder or bowels. This is a medical emergency and you will need surgery right away to decompress the nerve to avoid permanent damage.

    I hope your appt goes well tomorrow and please keep us posted on your condition. Take care
  • SpineAZSpineAZ WiscPosts: 1,084
    Although in the first note you said you are feeling better your second note seems to indicate you have severe pain in the back and sciatica (which would be related to the herniation). If you have any signs of un-ending nerve pain or numbness/tingling then you should consider some type of intervention. But you can pursue minimally invasive options as well as traditional surgery.

    Get a few opinions, perhaps one from a neurosurgeon and one from an orthopedic spine surgeon (or any two you choose).
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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