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2 MRI's in 6 weeks..different results..possible treatment?

horselady21hhorselady21 Posts: 174
edited 06/11/2012 - 8:58 AM in Back Surgery and Neck Surgery
Hi! This is an awesome forum...i have already read so much good advice and other's experiences and it has helped a lot! thanks to all who share.

After a successful microdiscectomy 2 yrs ago, I recently re-injured my lower back (very, very active lifestyle...work involves lots of lifting,etc so probably overdid it over the years). This pain was debilitating..worse than 2 yrs ago. I tried aggressive, non-surgical treatment by my family Dr., and was doing very well...until last week. I did some lifting that I shouldn't have done, and ended up not being able to walk on it at all, and was in bed for days. Finally had to go to neurosurgeon.

The original MRI (Oct 20) said this:
1. nerve root contact L3-L4 left neural foramen.

2. Annular tear and diffuse disc bulge L4-L5.

3. L5-S1 mild diffuse disc bulge/slight protrusion like herniation right paracentral region.

Since I had gotten better then got real bad, NS ordered a new MRI. This is the report from this one (Dec 7)

1. Moderate degenerative spinal stenosis L3-L4. Deg. disc bulge toward left and posterior w/left intraforaminal protrusion.

2. mild to moderate symmetrical dege. spinal stenosis L4-L5.

3. deg. disc L5-S1 no bulge or stenosis.

My questions: why so much difference between the 2? The first one doesn't even mention stenosis. Can a spine change tthat much in 6 weeks?? Or is it that each radiologist sees or looks for different things?

Any clue what surgery would be best for this? Almost everything I see for stenosis is a laminectomy and discectomy on the bulged disc. My appt is for Tues but I am trying to prepare things at home/work/life for what might be coming. I recovered very well from surgery 2 yrs ago...what should I expect time-wise if laminectomy is performed?

thanks for any help!



  • Welcome to Spine-Health and I'm glad you've enjoyed your stay. :-)

    Sometimes it all just in the wording. Also, stenosis is a compression of nerves, so in some ways it says the same things. I'm only saying this from experience, but only your doctor can really tell you what all this means. We can't read MRIs here, but we all know that you go to two different places and you'll get two different readings. No two places will report things the same - it doesn't mean they don't mean the same thing, they just use different wording generally speaking. Or maybe you did something to your back to cause more and/or different problems. Who knows? Only your doc.

    As to surgery, that one we can't answer either. That's wholly up to you and your doctor to decide. If you do have a more invasive surgery than a microdiscectomy, it will take much more time to heal. My lumbar TLIF took six weeks before I felt human again and over a year to feel "normal." (I never really feel normal, but as normal as I can get.)

    When do you see the NS to see what he recommends?

  • The radiologoist's report is an interpretation. You could show some films to him/her in the morning and the same set in the afternoon. You'd get two different reports.

    I'm going to send you a private message with a link to a helpful site since we can't post them here.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Thank you for the responses, and for the link, Paul. Lots of information there but I didn't see anything specific about stenosis. But everything else was helpful in understanding the MRI's.

    I go this tues to see what NS says. I already told him that I can't live like this...can't drive more than a few minutes, can't sit upright, pain wakes me up every few hours...I hope he can get this fixed quick.

    Then I guess it will be time for a lifestyle change!

    thanks again for your answers!
  • in the sense that the MRI mentions mild to moderate and not severe. Severe is a bad word in an MRI.

    I hope you can get your problems fixed with conservative and non-invasive treatments.

    Let us know what the doc says. Take care,
  • Sorry that you reinjured your spine. It is another example of how you must be so careful to never exceed your limitations after spinal surgery.

    One thing that is important is to try to determine where the pain is coming from. Having the MRI is just one piece of the puzzle.

    Google lower body dematome map, and see if your symptoms might be coming from a specific level. That may help you and your surgeon decide how to address the issue.

    Getting a couple of opinions is always a good idea, especially since you have already had surgery.

    If you have not done so yet, you need to become as knowledgeable about spinal pathology as you can be. Being proactive is vital so that you can make an informed decision.

    Good luck,

  • Hey there,

    1) Did you have the MRI's done at the same facility?
    I try to do that b/c it's easier to compare images.

    2) Did you have with/without contrast?
    I ask b/c typically if you had surgery, they should do it this way to help differentiate scar tissue. However, if you are allergic to the dye they may not do this.

    3) Did the MRI place know you've had surgery? did they know to compare the MRI to prior one?
    I ask b/c mine knows this and asks this. I suppose it helps the radiologist read it more quickly and provide notes relevant to the situation.

    At the end of the day the report is one piece.
    I just got back an MRI that I interpreted as did my GP as ....no significant change. I'm going to call my NS b/c I want him to look at it.

    I have increased leg pain and back pain. I suspect it is arthritis or something similar b/c it is very inconsistent. But I want him to look too just to be sure.

    Good luck at the doctor.
  • Hi! Yes, they were done at the same place and with contrast since I had prior surgery. 2 different radiologists. And they compared the new one to the old one and found more of a protrusion than the earlier one, but I was surprised that the first one didn't say anything at all about stenosis. Regardless, I tried all the non-invasive treatment and it got SO much worse that I am expecting and even hopeful for surgery so I can get my life back! My surgery 2 yrs ago was very successful, and I can't live as a slave to this pain!

    Funny you say your pain is inconsistent...mine seems to change from day to day also (except for the numbness in my leg and foot). I suspect that happens when there are multiple levels involved.

    Also, the dematome map of the body was very helpful...my NS was trying to determine which level was causing the most problem, and with this map, I can tell him 100% which ones are the culprit!
  • I had MicroD at L5S1 which failed right away.
    Had a 2nd one about 5 months after the 1st (long story on why I waited for month 5).

    Anyhow, it took about 3 months for me to get strength back and see reduction in leg pain.

    I never got feeling back from the day I lost it. So like you, that's the only consistent thing.

    I'm 2 years out of the revision. My MRI doesn't say much more than what I expected from having 2 surgeries but my GP said to talk to my NS to get his take.

    I hope they can get your pain down.
    I have a really high tolerance for pain and lately my OTC meds are not cutting it but I really do not want prescription meds if I can help it. I will avoid fusion until I hit that point with meds b/c I suspect the fusion really won't help much at this point.

    Good luck at the doctor. Keep me posted.
  • Just came from NS...actually the PA for the NS. He said no surgery, they want me to et steroid injections (unfortunately, I got an abscessed tooth over the weekend so I can't get the injections til after the infection is gone.) I asked him if the injections were a permanent fix and he seemed to waver. Also I told him I needed a prescription for pain medication as I was almost out of what my GP had prescribed, and he said I had to go back to GP for more. I just paid this guy over $300 cash and he spent a total of 10 minutes with me between 2 visits and I can't even get a prescription??!
    So called my GP requesting another prescription since the NS wouldn't, and now I have to go for another office visit for him (more $ which I don't have) because he is reluctant to prescribe! I can't live in this much pain! Are they afraid to prescribe now? Do they think I am not in this much pain? I can't drive without my leg and hip aching, can't eat out at restaurants, can't sit up for more than a few minutes...I am very upset at this whole thing. Am I going to have to live like this for the rest of my life??
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