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Back Problems Message Board

Back Problems Board Index

Have you consulted with a spine specialist or was the MRI ordered by yourPCP/family doctor? If the latter, you might want to make an appointment with either an fellowship-trained orthopedic spine or neuro surgeon for an accurate diagnosis and plan of treatment.

While your issues do not require surgery at this point, you do have some atypical spinal structure that may worsen as you age. It might be a good idea to have documentation of where you are now so you can track what may happen in the future.

Some of your atypical structure you were born with -- the sacralisation of two vertebrae, but other issues are part of spinal degeneration that comes with daily wear and tear and the aging process. Little can be done about these issues. However, there is a smallish disc bulge and protrusion that may resolve on its own or with conservative treatment modalities such as a course of physical therapy, medication and a series of epidural steroid injections.

I will try to explain a few terms so you will hopefully understand your condition a bit better. The sacralization of the lower lumbar vertebrae is a bit unusual in that it usually only happens in the L5 vertebra...and that occurrence is not common. This condition occurs in the womb during the formation of the bones of the spine when two vertebrae do not separate completely. It occurs between the lumbar and sacral sections of the spine...thus is referred to as "transitional lumbosacral" vertebrae or anatomy. Often it causes no issues whatsoever...but, in some people it can become a source of pain.

At L3-4 there is degenerative disc disease which included the disc bulge/protrusion and some spinal arthritis in the joint at this level. Part of the disc material is protruding from the disc and is causing stenosis or narrowing of the neuroforamina at this level...this is an opening that allows the spinal nerve to exit the spine and go out to the area of the body it innervates. When something like a disc bulge takes up space and pushes into this opening, there is not sufficient room for the nerve to be able to function normally. Thus, you end up with some symptoms like pain, burning, tingling, even numbness that can be felt in the back or anywhere along the path of the nerve...(radiating pain). If the disc can reabsorb, the foramen would open back up and the nerve would be decompressed.

You will note the foraminal stenosis is affecting the L3 nerve. This runs from the hip, wrapping around-across the front of the thigh and down the inner side of leg. It is worse on the left side.

There is also a small disc bulge at the L4-5 level.

Hope this helps.

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