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herniated disc

This is my report of my mri with contrast compared to my one without. no one can seem to tell me what is going on my legs are going numb on me and my doctor is saying that it is not caused by my herniated disc. can someone please help me understand what this is saying, im 36 years old and can not sit or stand for long periods of time i am in pain constantly and no one can help.

The alignment is normal. Disc spaces actually are well maintained although there is moderate desiccation/dehydration from L3-S1. There are focal marrow signal changes involving the anterior aspect of the inferior portion of the L4 vertebral body, much more prominent on the right than on the left. I see no evidence of bone marrow edema. Marrow signal intensity is otherwise somewhat heterogeneous, but i see no focal abnormalities and the degree of heterogeneity is not unusual for menstruation female and likely represents some residual prominent red marrow. No fracture identified. I have a good evaluation of the cauda equina as well as the distal cord. Conus terminates at the L1-L2 level and i have a good evaluation the cord from T10 downward. Cord normal in contour,caliber,course and signal intensity. I see no abnormal cord or nerve root enhancement. Limited evaluation paravertebral soft tissues unremarkable.

L1-L2: No significant abnormality.

L2-L3: No significant abnormality. L3-L4 circumferential disc bulge with a posterior midline area of T2 hyperintensity consistent with a tiny annular tear. Moderate bilateral ligamenemtum flavum thickening. Mild bilateral facet disease. Mild bilateral lateral recess narrowing. No significant canal or neural foraminal narrowing. Findings not significantly changed from prior.

L4-L5: Circumferential disc bulge with a superinposed tiny midline disc protrusion with high T2 signal consistent with a focal annular tear. Mild bilateral ligamentum flavum thickening. Very mild bilateral lateral recess narrowing. No significant canal or neural foraminal narrowing.

L5-S1: again there is a focal disc extrusion eccentric to the left side. Finding main teens contiguity with the parent L5-S1 disc. The disc extrusion measures approximately 14x9x10 mm, not significantly changet by my measurements on the prior. Again there is focal compression of the transiting left S1 nerve root. Finding actually also abuts the S2 nerve root. No neural foraminal narrowing,

1. No significant change from oct. 19,2012.
2. Focal left-sided disc extrusion L5-S1 causing significant compromise of the transiting left s1 nerve root.
3. Relatively mild degenerative changes L3-L4 and L4-L5, with areas of mild bilateral lateral recess narrowing. Clinical significance of these questionable, however the findings are prominent for patient age.
4. No evidence of distal cord/conus compromise. No evidence of a generalized process involving the cauda equina. the distribution of the nerve roots in the thecal sac is normal and there is no abnormal enhancement.


  • Hi, sorry to hear that you have numb legs.

    Can you please give us more details of your pain and numbness, and history of your back problem and current medications.

    We are not doctors and can't interpret MRI reports. However, like you, I had a herniated disc at L5/S1 region that was pressing on my nerve (in my case both L5 & S1) (yours is pressing on S1 and possibly S2 nerves).

    One thing I have learned, is that diagnosing, medicating and surgical intervention is an art and not a science. Many doctors have different ideas and approaches. It's not like having an appendicitis, where it is black and white and the 'fix' is universally recognised and straight forward and routine. The patient is required to understand and interact with the doctors from a high knowledge base or risk making the wrong decisions which can be life changing (and even when they are the right ones).

    So I encourage you to use the knowledge here to educate yourself. Start with the FAQ at top of page and then read the conditions and treatment tabs on home page. It will take you a while, but better before than after the decision making.

    We can help you and support you through this health issue.

    Looking forward to hearing from you.
  • ok so i have been having trouble with my back since i was young about 16 i played softball and the backcatcher came down on me when i was sliding into homeplate and twisted my pelvis. I started seeing a chiropracter then and have continued to see one throughout my 36 years, and have had alot of injuries to the back like falling down a flight of stair with my bottom hitting every step, getting bucked off of horses, falling out of my deerstand, and boats. i worked most of my life in restraunts and had many slip and falls in the dish area and kitchen. i have been without insurance for about 6 years and haven't been able to see the doctor alot, i am unemployed bc i can't stand or sit for long periods of time and can't do alot of walking bc it hurts when i walk. i was just approved for 6 months indigent care from our hospital and recently had this mri. i am currently taking meloxicam 10mg 1day, accuretic 20/25 mg 1day, celexa 15mg 1day, cyclobenzeprime 10mg 3day, and endocets 10mg every 6hrs.
  • DaveFusionDDaveFusion Posts: 476
    edited 12/18/2012 - 7:04 PM
    Have you seen any spine specialists? From what you are saying here, I would suggest that you get a referral to a good spine specialist. A 14x9x10 disc extrusion is very big as herniated discs go and sounds like it significantly compressing the left s1 nerve root, hence possibly the numbness like I too have from the same cause. Same nerve and side! Also the L5 for me.

    Many teaching hospitals have top surgeons associated with them and may be prepared to take you on as I understand you don't have insurance. There are posts here that describe good ways of going about this. May take some time to find but well worth the effort. And you'll learn lots along the way.

    Numbness can be from other illnesses than compressed nerves. Im not a doctor. An EMG test may be able to quantify if it is lumbar nerve root cause or not. If you use search function with EMG as keyword, you will be able to read peer reviewed and physician written articles as well as patient posts about that topic. You could try numbness, nerve damage, extrusion, etc.

    There are "38 question to ask a spine specialist" in the FAQ section (see at top of page) that you could ask you doctor. This will give quite a bit to think about. The other items in the FAQ are a good read. I encourage you to look at the conditions tab on the home page and read up.
  • yes i have seen a surgeon and she says that i need physical theraopy. 6months and she wants to do a nerve block but i dont feel comfortable with the nerve block after all of the menengitis outbreak. she said that my back would not be causing the numbness in my right leg and my incontinence. i asked for a second oppinion and she made me one with her partner!! i have indigent care thru our local hospital and i think they are just passing me around bc no one wants to operate bc they wont get paid as much if i had insurance that they could charge.
  • davrunnerddavrunner Posts: 478
    edited 12/21/2012 - 7:21 AM
    Not talking specifically about your mri, but a back problems most definately can cause leg numbness and incontinence. Yes you are in charge of your own health but if you don't try the PT and the nerve block you aren't helping yourself. I am also concerned about the menegitis outbreak but will continue to get lumbar blocks until they stop working.
    Blocks are for more than pain relief they are also used by the Docs to determine if you are a candidate for surgery or if surgery will help you. Your chances of pain relief from surgery are better if a block works. Understand the concern but it was only one compounding pharmacy that caused the menegitis.
    Believe your last statement to be true that those under indigent care will receive only conservative treatment due to the cost that must be made up for some of the surgeries. My sister has indigent care in Ca and needs a knee replacement and they won't do it, they just give her meds for arthritis.
    Also wanted to say that a second opinion comes from a different practice that has no ties with the first opinion. You didn't get a second opinion....
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • i have a focal left-sided disc extrusion measuring 14x9x10 in the L5-S1 causing significant compromise of the transiting left S1 nerve root. and what is mild bilateral disc disease?? please help
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