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Here is my MRI and 6 view Spine Xray with lateral flexion and extension diagnosis:

The conus medullaris is normal in appearance and location. There is degenerative endplate change at L5-S1 with moderate disc space narrowing and disc desiccation. Otherwise, no abnormal bone marrow signal. There is disc desiccation and mild disc space narrowing at L4-L5 with a posterior annular tear.

Minimal broad-based disc bulge at L3-L4 with minimal ventral flattening of the thecal sac.
At L4-L5 broad-based disc bulge causes mild ventral impression on the thecal sac. Again identified is the posterior annular tear at this level.
At L5-S1 there is left paracentral disc herniation measuring approximately 1.7 cm traversely and 1 cm anteroposterior in dimension. This causes mild ventral impression on the thecal sac and does displace the left S1 nerve root posteriorly and laterally with some effacement of fat. It also appears to abut the right S1 nerve root with some displacement of the fat as well.
1. Large disc herniation at L5-S1, eccentric to the left causing only mild impression on the thecal sac. This does appear to efface (not sure of that word, copier left a line there)the ventral fat about both intradural S1 nerve roots and displaces the left S1 nerve root posteriorly and laterally.
2. Broad-based disc bulge with annular tear at L4-L5 with mild ventral impression on the thecal sac.


Standing radiographs were obtained including lateral flexion and extension views.

There is marked disc space narrowing at L5-S1 with Vacuum disc phenomenon with some mild spurring. There is no subluxation. Pedicles are intact.

Mild to moderate degenerative changes in the lower lumbar spine.

I have had 3 rounds of PT for about 4-6 weeks each, I always ended up quitting right before I was supposed to be done because it seemed to make things worse. I had 1 epidural and 1 caudal injection, which made things sore for a few days afterwards, then back to normal, no help. Then I had the discogram and it hurt quite a bit on L4-L5, but L5-S1 was excruiating, and the same pain that bothers me. L4-L5 was torn a little (on top I think) and L5-S1 was severly torn. I have some pain radiating down each leg, but I can deal with that its the hoorible pain in the middle of my back and left butt cheek and left hip that I can't deal with. The disc space between L5-S1 is very narrow, the Dr had a hard time doing the discogram on that one cause he was having problems getting the needle in.

I am seeing the best neurosurgeon in this area (Dr Palavali, Flint, MI), and he thinks IDET is worth a try, because I REALLY don't want fusion or replacement. This all started about 1.5 years ago due to a car accident, and I'm 28 years old and was athletic.

Could someone tell me what vacuum disc phenomenon is I can't seem to find an explanation on the web that I understand, and I really don't think the IDET will help, but if there is a chance it will I'm willing to try it, It is scheduled for Monday Jan 15th. This has been getting progressively worse, and I have been off work for the past 2 months, and I have been very miserable and depressed. 2 weeks ago the neurosurgeon took over my care from the Pain Management Dr, and switched me from 40mg oxycontin 2x a day and 10/325 percocet 8x a day to 4 vicodin es a day, and I can't even get off the couch hardly. The 4 vicodin es wasn't even enough to keep me from going through withdrals, so on top of the back pain I was having horrible withdrawls for about a week.

I just got the X-rays today, and my Dr has not seen the report yet, and I was wondering if the x-ray report showed anything the MRI didn't show, that he might need to know before going ahead with the IDET.

I kinda understand the MRI report, but if someone could also explain that better I would appreciate it. So any thoughts on this matter would be appreciated since I only have 3 days to cancel the IDET.


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