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Back Problems Message Board


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Almost three weeks ago I had bilateral SI joint injections - steroid. A few hours after the injections when the feeling was coming back I started to have severe pain on my right buttox (where the injection was done), on the outside of my right hip, and down the outside of my right leg to my knee. The doctor does not feel the SI joint injection is what is causing the pain. I find it odd I have never have pain in my leg prior to the injections. He wanted an MRI to try to figure out what was going on. In the meantime I am still in severe pain. Nothing seems to help the pain.

Can anyone tell me what they think after looking at my MRI? Can anyone tell me how they figure what grade a 3mm anterolisthesis is at L4-5?


FINDINGS: Interbody spacer device noted at L3-4. There is 3 mm anterolisthesis at L4-5 which is new from prior exam. Alignment is otherwise anatomic. Lumbar vertebra have normal height and marrow signal. There is loss of disc space height at L4-5 consistent with degenerative disc changes progressed from prior exams. The conus medullaris terminates at the L1 level and has normal morphology and signal. The nerve roots of the cauda equina appear redundant likely reflecting sequelae of spinal canal stenosis. No abnormal enhancement is present within the thecal sac.
L5-S1: There are mild degenerative changes of the facets without significant spinal canal or foraminal narrowing. There is a small right intraspinal synovial cyst without significant associated foraminal narrowing.
L4-5: Diffuse disc bulge with facet arthropathy and degenerative thickening of the ligamentum flavum results in severe spinal canal stenosis progressed from prior exam. There are small facet joint effusions. There is complete effacement of CSF within the thecal sac which measures 4 mm in AP dimension. Mild bilateral foraminal narrowing has progressed to secondary to loss of disc space height.
L3-4: Patent.
L2-3: Mild diffuse disc bulge is slightly progressed. There is mild spinal canal narrowing which is progressed. No significant foraminal narrowing.
L1-2: Patent.
T12-L1: Patent.
T11-12: Patent.
T10-11: There is a central disc protrusion resulting in mild spinal canal narrowing. There is no significant foraminal narrowing.
The perivertebral soft tissues are unremarkable.
IMPRESSION:
1. Status post interbody lumbar fusion surgery at L3-4. Interval progression of degenerative disc changes and disc herniation at L4-5. Facet arthropathy at L4-5 is also progressed with associated anterolisthesis. Fairly severe spinal canal stenosis at L4-5 has progressed.

Thanks so much!
Jill





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