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My son's doctor told him that injections might help him. This is what the MRI showed. He had to quit his job Friday because he cannot do the (manual)work anymore. I can't understand how injections could work for this, but what do I know? He is only allowed one consult with his insurance and I don't know whether to have him go to the Spine Clinic at the U of PA or directly to a neurosurgeon. Any suggestions. He's 34.

Bobi


Here what the MRI says (encapsulated):

There is grade II spondylolisthesis of L5-S1 associated with spondylolysis. There is slight retrolisthesis of L4 on L5. There is marked loss of disc height at L5-S1 associated with these findings, and there is a reactive marrow pattern, which is subacute. There is diffuse disc bulging at L4-5 and L5-S1 with a radial tear of the L4-5 annulus. there is distortion of the spinal canal due to the spondylolisthesis.

Impression:

There is grade II anterolisthesis of L5 on S1 associated with spondylolysis and advanced facet hypertrophy contributing to rather (and the next part is underlined) marked bilateral L5 neural foraminal narrowing and borderline canal diameter at this level. Otherwise mild bilateral L4-neural foraminal narrowing due to facet hypertrophy.
grade II anterolisthesis of L5 on S1 associated with spondylolysis and advanced facet hypertrophy contributing to rather [U]marked bilateral L5 neural foraminal narrowing[/U] and borderline canal diameter at this level. Otherwise mild bilateral L4-neural foraminal narrowing due to facet hypertrophy.>
The anterolisthesis of L5 on S1 basically means the L5 vertabrae has collapsed onto S1. Injections will NOT help that. The marked forminal narrowing will NOT be helped by injections. The radial tear of the annulus will NOT be helped by injections.
I would whole-heartedly agree he needs seen by a neuro, not an ortho, ASAP. The sooner he gets appropriate treatment, the better his chances for recovery. U of PA has some awesome orthos, but I think the neurosurgeons would be a better choice.
Did he injure his back lifting? In a fall? Other than pain of the back, other symptoms?





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