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MRI Interpretation - Severe back/hip/leg/ankle pain

Hello. I am a new member and have been muddling my way through the back pain healthcare system and completely lost at this point and need some "real person" advice. My apologies for the long post, but want to try and explain myself clearly. My primary care physician is useless and isn't someone to I can depend on for proper guidance and support. I have worked in healthcare for 20 years in an administrative fashion and I'm not unfamiliar with the medical language but in this event, my doctor isn't helpful at all to try and explain. I am a 45 year old woman and generally good health otherwise. This issue has stopped me in my tracks. I had back surgery for L4-L5 a little over 2 years ago for bulging discs. Was in pain but nothing compared to what I'm experiencing now. I recovered well from that surgery and seemed good for for quite some time. Over the past 5 months my pain increased, with new symptoms and now the pain is simply excruciating and is basically felt in my left hip, travels down my back thigh, knee, calf and into my foot. It's painful to sit, stand, elevating doesn't help, alternating heat and cold, etc. If I sneeze or cough I feel like I'm going to be pass out as if a nerve is being pinched. I've tried stretching as I thought it might be pinched nerve and found some great stretching videos on YouTube. All of this with no relief. I know I'm taking too much Advil/Motrin than I should be (causing nausea and bleeding) and I alternate with Aleve. I have been prescribed 1 norco 3x a day with soma and that doesn't help either. I work fulltime the pain is so bad I'm unable to focus as I should be. I recently demanded another MRI and received the following results. My primary Doctor did refer me to a Neurologist and I'm awaiting an appt to be scheduled. I'd like to get some advice and opinions so I don't walk into this appointment uninformed and the right questions I should be asking. My MRI results were as follows:

FINDINGS: All the lumbar discs except for L2-3 disc have decreased signal on T2-weighted images consistent with element of degeneration. Previously L4-5 and L5-S1 discs have decreased signal on T2-weighted images. Patient has had interval surgery involving the poster elements at L4-5 level. No acute vertebral body compression fracture or spondyloysis. Conus terminates normally at L1-2 level. No intraspinal enhancing lesions.

T12-L1: No new focal disc herniation or high-grade spinal stenosis. Exiting nerve sleeves are not displaced in the foramina.
Common bile duct measures 11mm in width.

L1-2: Previously noted broad-based posterior central and right center disc protrusion has increased in size and now measures 3mm in AP diameter. There is mild compression of the right ventral aspect of the thecal sac. Exiting nerve sleeves are not displaced in the foramina.

L2-3: Broad-based 2mm disc protrusion, facet joint degenerative changes and ligamentum flavum hypertrophy result in mild to moderate spinal stenosis. This has increased since the prior exam, mainly due to increase in size of the disc protrusion. Exiting nerve sleeves are not displaced in the foramina.

L3-4: Short pedicles, bilateral facet joint degenerative changes, ligamentum flavum hypertrophy and disc bulge result in moderate spinal stenosis that has progressed since the prior exam. Mild bilateral foraminal narrowing without displacement of exiting nerve sleeves in the foramina.

L4-5: Postsurgical changes at this level. Enhancing granulation tissue found in the epidural space. Bilateral facet joint degenerative changes. Broad-based posterior right of center 3mm disc protrusion appears to persist and results in mild compression of the right ventral aspect of the thecal sac. Exiting L4 nerve sleeves are not displaced in the foramina.

L5-S1: Broad-based left lateral and left of center disc protrusion and osteophytes compromise the left foramen and appear to abut the exiting left L5 nerve sleeve beyond the left foramen. No high-grade thecal sac compression.

I thank you in advance for any advice and questions i should be asking of the Neurologist once and if I get a visit.
Jennifer Cameron


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