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Back Problems Message Board


Back Problems Board Index


What to do?
Aug 2, 2011
I have been having back problems for a few years now. I have had 3 Epidurals, 2 Facet Joint Injections, and a Rhizotomy. Looks like there may be another Rhizotomy in my future as the last lone I had is wearing off after about 6 months. I also have Sciatica down both legs. It even bothers me when I sleep in certain positions. I cannot walk too long or sit to long in the same position. I opted to do pain management instead of seeing a regular MD because I was afraid he would say surgery but now I am wondering if that is an option I should consider. I am afraid to do to much for fear of permanantly damaging the nerves. my latest MRI shows the following:

Report:
Sagittal and axial T2, sagittal T1, sagittal STIR and axial
proton density weighted sequences of the lumbar spine was
performed. Comparison made with prior MRI of the lumbar spine
dated 2/20/2010.
Findings: The current study reveals no acute compression
fractures nor retropulsed fragments. Vertebral bodies exhibit
relatively normal stature. Slight straightening of the normal
lumbar lordosis again noted. There has been slight increase in
edematous changes involving the L4-L5 end plates, latter more so
than former consistent with type I discogenic sclerosis. The
remaining vertebral bodies otherwise exhibit relatively normal
signal.
In addition to the aforementioned type I discogenic sclerosis at
the L4-L5 level, there is also mild cortical end plate
irregularity and vacuum disc phenomenon. Small= broad-based
osteophytic ridge disc bulge complex is again seen extending peripherally into the inferior margins of both exit foramina
where the disc changes appear most prominent. Facets remain quite
hypertrophic with intrafacetal fluid and buckled ligamentum
flavum. There is resultant mild flattening of the ventral
surface of the thecal sac and mild posterior displacement of the
nearly exiting intrathecal L5 nerve roots. Overall central
canal remains adequate despite the ventral surface flattening as
well as compressive effects along the posterolateral borders of
the thecal sac by the encroaching facets. Exit foramina are
mildly narrow on the right side and marginal to minimally narrow
on the left.
At the L5-S1 level, there is also disc desiccation and mild
posterior disc space narrowing. Small central and bilateral
osteophytic ridge disc bulge complex minimally indents the
ventral surface of the thecal sac however no significant
intrathecal exiting nerve root deformity noted. Central canal
does appear adequate. Exit foramina are also adequate on the
right and marginal and mildly narrowed on the left.
At the L3-L4 level, there is disc desiccation however the disc
space height is relatively maintained. Small osteophytic ridge
disc bulge complex results in mild flattening of the
anterolateral borders of the thecal sac bilaterally, more so on
the right side. Disc bulging ridge complex extends into the
inferior margins of both exit foramina. Facets are moderately
hypertrophic. Central canal is adequate. Exit foramina are also
adequate.
At the L2-L3 level, there is disc desiccation. There is very
minimal anterior disc space narrowing. Some minor proximal
foraminal disc bulging changes are present. Facets are moderately
hypertrophic. Central canal and exit foramina appear adequate.
Conus terminates at approximately the upper L1 level.
Impression:
Mild multilevel degenerative spondylosis most notably affecting
the L4-L5 level, as described. Type I discogenic sclerosis has
progressed slightly at this level. See above discussion for
additional findings and details.
Not really too sure what my next step should be. Do I see an Orthopedist, do I see a Neurologist or what?? Any advice is welcomed.





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