Radiology/Low Back MRI


I had an MRI in Feb. of 2011 the results of which were:

*Mild mixed Modic type |-|| discongenic endplate changes at L4-5.  
Otherwise normal lumbar ventebrae.
*Normal conus medullaris that terminates at the L1 level.
*L3-L4:Reduced disk hydration with mild posterior disk space
narrowing. Minor annular bulging with minimal ventral endplate
spondylosis and minor facet arthrosis. Normal central canal and
lateral recesses with normal bilateral intervertebral neural
*L4-L5:Reduced disk hydration with mild disk space narrowing and
circumferential annular bulging with a large midline and left
paracentral disk herniation of the extrusion type measuring
approx. 7x12x18 mm in AP, transverse and cephalocaudal
dimensions, respectively, with cephalad migration in the anterior
epidural space posterior to the L4 vertebral body. Mild endplate  
spondylosis and bilateral facet arthrosis. Marked central canal
stenosis with thecal sac compression with visualized midline
residual AP thecal sac diameter of approx. 3 mm. Marked left
greater than right lateral recess stenosis. Patent right neural
foramen with proximal left foraminal narrowing with distal neural
foramen remaining patent.
*L5-S1:Reduced disk hydration with adequately maintained disk
height. Minor annular bulge with no substantial endplate
spondylosis. Mild bilateral facet arthrosis. Normal central canal
and lateral recesses with normal bilateral neural foramina.

*IMPRESSION-Large, cephaled migrating disk extrusion at L4-5 with
minor annular bulge, endplate spondlyosis and mild bilateral
facet arthrosis, with resultant severe central canal and left
greater than right lateral recess stenosis with accompanying
neural impingement.

Initially I began treatment with a chiropractor while I waited to see a surgeon. I was impressed with the results from the chiro, and did not like the surgeon. My back is hurting again, the pain immediately went down my leg there is also occasional numbness. Is it possible to see positive results again from chiropractic care or is this just going to progress? Is it bad or not so bad (I always thought not so bad, now I wonder).



Very sorry for  delay in reply.

After all this, if you last MRI was in Feb 2011, you need another MRI to see if the L4-5 extrusion changed? got better? got worse?  Some people can get away without surgery for extrusions but sometimes there is no way around it especially if one develops a weakness.
At this point since your symptoms changed from getting better another MRI is necessary to figure things out.

Hope this helps somewhat.



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Michael K.


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