Radiology/Lumbar MRI report
I obtained an MRI for my back and leg pain. I was wondering what the treatement options are. The results are:
L4-5 Broad based disc bulge. Superimposed central and left paracentral disc herniation is present. Annular fissure is also present in the posterior centtral portion of the disc. There is moderate spinal stenosis. Facet hypertrophy is present which contributes to mild to moderate left foraminal stenosis.
L5-S1. Broad based disc bulge. No significant spinal stenosis. Minimal left frontal and lateral recess stenosis.
Impression: Central and left paracentral disc herniation and annular fissure at L4-L5 causes moderate spinal and bilateral, left greater than right, lateral reacess and foraminal stenosis.
The treatments vary a great deal depending on your symptoms. I am a radiologist and do not treat back pain but I will give you some information on what your options are.
Firstly, one needs to figure out exactly if your pain down the leg is due to the disk at these levels. Is it your left leg? then possibly L45 disk may be the cause. may be...not definitely. If it your right leg..well then..it is even less likely that the findings are related. It is often the case that MRI findings do not correlate with any of the symptoms. While there is moderate stenosis of the canal that may not mean much. It may..but again need to be correlated with exact symptoms.
Treatments vary from invasive to non invasive. I would strongly encourage you to exaust all non invasive approaches first. Physical therapy is number one way to deal with it and see if with proper exercises the symptoms will go away. What may also happen is that disc that is protruded (herniated) may be resorbed by your body at some point. If your doctors correlate L4 or L5 symptoms they may offer you injection of lidocaine and steroid to see if the symptoms go away and thereby documneting the cause of pain. Surgery has its place in back pain but needs to be your last resort if you are unable to do what you usually do or the pain is extreme. Surgeries on back are very complicated in terms of outcomes they may help initially but have more problems later...again not 100% but.
Let me know if you have any further questions.
Hope this helped somewhat.