I just got the results of my MRI and need the decoder ring!
History - Over the past couple of years I have been dealing with some pretty bad back and leg pain. Last year the pain started getting much worse and I had an MRI about 14 months ago.
At the time I was using Kaiser for my insurance and after the MRI I was sent to a spinal specialist. The spinal specialist had me first try physical therapy for about six months, during this time the pain got worse.
After the physical therapy the spinal doctor had me doing epidural steroid injections into my spine. Those would help for a week or two but then would gradually stop helping. We did four rounds of injections, after which the doctor seemed to just give up.
During this time my other doctor was trying to treat the pain and she tried several different medications, I really don't remember all of what she had me taking but it was a long list.
The main form of pain treatment has been Vicodin/Norco. I started off about 18 months ago taking 2-4 vicodin and now am up to 6-8 Norco a day. The problem is that even with this level of medication I am still constantly feeling severe pain.
The pain that I feel is as follows. In my low back I feel sharp pain on the left side at L4 and L5. On the right side I do not feel sharp pain but I feel what I can only describe as a lot of pressure (sometimes I can lay on my back and rock my legs back and forth and I will feel a pop, when that happens the pressure in the right side will feel a lot better). On both sides my butt is constantly numb and painful. The backs of my legs also feel constantly numb. On my left leg I feel numbness and tingling down the side and back of my leg extending all the way to my foot. A lot of times now I will feel tingling down my left leg on both the outside of the leg as well as the area around my ankle and foot. Occasionally I feel some numbness and tingling on the inside of my legs and my groin area, I have never had any incontinence but when the inside of my legs feels numb I do feel like someone had just kicked me in the groin. These symptoms seem to follow me if I am sitting or standing alike. Every once in awhile when I step just right, going up the stairs or twisting funny, my left leg will buckle a little bit. Also if I twist just right I will feel twinges of pain shoot down my left leg.
I have a new doctor that I got after the first of the year, and recently he put in an order for an MRI. They tried fitting me in a high-field (tube) MRI unit but I could not fit because my shoulders were too wide, so I ended up going and getting an open MRI. I went in on Tuesday and got the MRI and today a picked up the report from them. Below is how it reads. Can you guys help me decipher this and help me understand what it means.
Exam: MRI of the lumbar spine:
History: Bilateral lower extremity pain and weakness for evaluation.
Technique: MRI of the lumbosacral spine was performed on the Siemens Concerto MRI scanner using the following pulse sequences: Sagittal T2-weighted, sagittal T1-weighted, axial T2-weighted, axial T1-weighted, and coronal T2-weighting.
Findings: The lumbar vertebral bodies are normal in height. There is a 6 mm retrolisthesis of L4 on L5. Alignment at the remaining levels is maintained. The conus terminates at the normal level. The examination is technically limited due to the patient's body habitus.
L1-2: There is no evidence of disk bulge or protrusion. There is no evidence of central canal or neural forminal stenosis.
L2-3: There is no evidence of disk bulge or protrusion. There is moderate bilateral facet and ligamentous hypertrophy, which causes a mild degree of central canal stenosis and mild to moderate stenosis of both lateral recesses. There is no evidence of central canal or neural forminal stenosis.
L3-4: There is no evidence of disc bulge or protrusion. There is moderate bilateral facet and ligamentous hypertrophy, which causes a mild degree of central canal stenosis and mild to moderate stenosis of both lateral recesses. There is no evidence of central canal or neural forminal stenosis.
L4-5: The disc is desiccated. There is a 3-4 mm disc bulge with focality in the posterior central location. There is moderate bilateral facet hypertrophy. There is no evidence of central canal stenosis. There is mild bilateral neural forminal stenosis.
L5-S1: There is a 3 mm disc bulge. There is mild bilateral facet hypertrophy. There is no evidence of central canal stenosis. There appears to be moderate left-sides neural forminal stenosis.
1) Technically limited exam due to the patient's body habitus.
2) Multilevel lumbar spondylosis with varying degrees of central canal and neural forminal stenosis as detailed above.
Any help you guys can give me decoding this would be great. Is this a big deal, should I be really concerned?
Thanks in advance for any help.