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Update MRI results

AnonymousUserAAnonymousUser Posts: 49,553
Hello everyone,

So i just got an email from my doc telling me about my MRI report results. It says I have a disk bulge at l5/s1 , but that there is no nerve compression. He doesn't think my pain is being caused from this. I am glad that its not really bad, but now i am confused as to why i have the pain going down my left side. :(

the report also said something that i am puzzled about-- it said i have a " conjoined nerve root". does anyone know what that means? i will paste the report.

MRI lumbar spine.

TECHNIQUE: T1 and T2-weighted sagittal and axial sequences.


Osseous alignment: Normal.

Bone marrow signal: Normal.

Disc hydration status: Diminished at L5-S1.

Paraspinous soft tissues: Normal.

Conus medullaris: Normal.

Intervertebral disc spaces:

L1-L2: Normal.

L2-L3: Normal.

L3-L4: Normal.

L4-L5: Normal.

L5-S1: Mild diffuse disc bulge. There is no evidence subluxation. No nerve
root compression is identified. Incidental note is made of conjoined right L5
and S1 nerve root.

Mild degenerative disc changes at L5-S1.



  • The conjoined nerve root is most likely something you were born with. It most commonly occurs at the L5-S1 level. It is basically just what it sounds like...the two nerves form together in the dural sac. They may not separate at all and will both come out of the same foramina or they may separate as they exit the spine and come out of different foramen. Usually it doesn't cause any problems and people are unaware they have this condition until it is discovered during surgery or in diagnostic testing, as is your case.

    It can be a problem in reading MRIs though as sometimes it gives the appearance of a disc herniation or a disk fragment.
  • I understand how you can have pain at L5-S1 with a bulge as I'm sure that caused me pain before the tear. check www.chirogeek.com It has a lot of info. I would get your primary Dr to give you another referral to a pain management Dr and another Ortho or NeuroSurgeon. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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  • I think your doctor should order a ct/myelogram to confirm that the nerve is not compressed. The MRI can be inconclusive or miss something like that. True nerve impingement can be found using this method. Take care
  • Hi ,

    Thanks for the responses. It's interesting to learn about the conjoined nerve thing. I will probably ask for a referral to a spine specialist since i am mainly dealing with my regular doctor so far. I will bring my report and films and i will ask about the ct/ myelogram. :)

    I am really at a loss now as to what is causing all of my pain. I feel like i am falling apart! my symptoms are weird which is the reason my doctor was hesitant to give me my MRI i guess. :-/

    Current symptoms:

    lower back pain that gets worse when i sit and when i walk. This pain isn't excruciating.

    What is really unbearable is the constant hip/butt pain. When i sit for longer than 10 or 15 minutes and when i walk for longer than 10 or 15 minutes i will get horrible pain but it varies. sometimes i will feel the pain go down my back to the butt to the front of my thigh with a burning sensation just above the knee area. other times I'll get the pain in hip/butt and burning in knee but nothing in between like in my thigh area....which is confusing. its not always a straight line that i can draw.

    More recent symptoms:

    Random cramps in the back of my calf and tingling sensation on my toes (the feeling you get when your foot wakes up).

    I have also had the weird sensation of feeling like something touched my big toe when i go to look nothing is there. I have thought it was a bug or something lol.

    All this on my left side by the way.

    Does this sound like sciatica at all? I have no idea what it could be.

    I am going to mention all this to my doctor at my next appointment but was wondering if anyone had similar symptoms.

    I have since been thinking that the previous pain in my ankle is probably not related. before the back pain trouble i had pain when i put my weight on my ankle and when i walked. That went away, but now it has decided to return. This is also on my left side. :-( I am thinking of asking my doctor for a hip and knee x-ray as i'm wondering if i could have separate issues all at once instead of it all being related..

    thanks, sorry for such a long post.

  • All your symptoms really sound like those from nerve pain. It can vary so much, and it can also vary from day to day, hour to hour. In other words, it does not have to be predictable to be nerve pain. It can be on one side one day, and in the other leg the next. And, yes, all these crazy symptoms can all be coming from one compressed nerve root. Run a search for a dermatome map and you will see just what areas are innervated by the L5 and S1 nerves.

    Sciatica is just a generalized term that laymen use to describe pain that runs from the lower back, across the buttock and hip, down the back of the leg and sometimes into the foot and toes.

    And by the way, the report from your MRI is the opinion of one radiologist. Often a spinal specialist looking at the films will see things that were missed by the radiologist. I would suggest you make an appointment with a fellowship-trained spinal specialist, either an orthopedic surgeon or a neurosurgeon who devotes his practice to issues of the back and spine. While family doctors are well-meaning, they do not have specific, detailed training in the back and spine. While they may talk a good game and make you think they know what they are talking about, you can waste a lot of valuable time with a misdiagnosis. I would be amazed if you do not have a compressed nerve with the symptoms you have described.
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  • All of your symptoms sounds familiar because I had them, too. A bulging disc at L5 S1 was pressing on the sciatic nerve, and in the MRI films you could see it.

    Perhaps, you do need more testing....and I would definitely seek a spine therapist. When my internist got the results of my MRI showing a bulging disc, she advised me to see a neurosurgeon.

    Good luck!
  • All I can say is WOW! I'm very envious of your "clean" looking MRI report!

    No canal stenosis, no bulging discs, no degenerative changes of facet joints, etc...

    Sounds like you have a hodge podge of various symptoms.

    Have you considered having a Gait analysis? Biomechanical abnormalities can cause many or all of the symptoms you describe. Something as simple as orthotics and good quality shoes might help your situation.

    Stick with the physical therapy, strengthen your "core", and consider seeing a physiotherapist (rehab doc, MD). If you truly have a nerve impingement an EMG will detect it.

    From what I've experienced some orthopedic surgeons, neurosurgeons, and other spine specialists won't even agree to making an appointment until you've been through months of PT that was ineffective, EMG's that indicate muscle/nerve damage, multiple ESI's, etc... It's like you need to know a secret password for entrance to their office. And why would anyone want to meet with one of these docs unless they WANTED surgery. Eeek!

    Good Luck!

    Good Luck!

  • Thanks,

    I'm really glad and relieved that it wasn't something worse. just the l5 s1 bulge and mild degeneration.

    The only concern i have right now is from the pain and finding out if it is a nerve being pinched. I hope it is not and that its something simple. :)

    I have an appointment with my doc on Tuesday and we are going to discuss the next step. I plan to ask him if we can try to see if my problem is coming from elsewhere such as what you suggested ( gait, my hip pain etc.) and hopefully it will turn out to be an unrelated problem.

    I have not been to physical therapy for about 2 weeks. (my PT said i didn't have to go as much, because i had some really good days) of course a few days later I had a really bad flare up that has lasted about 2 weeks. I do have an appointment coming up that i will keep. I feel a lot better doing physical therapy now that i know what the problem is.

    I wasn't to sure of it before because i was afraid i would be damaged more, since we didn't really know what was wrong.

    Thanks to all who responded i will keep you posted on what my doc has to say and I remain hopeful. :)
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