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Ouch my Back!
Jun 10, 2012
Hello all,
Was just curious about my MRI. I know we are not doctors. But some opinions would probably calm me a little. I am having horrible back pain, almost feels like nerve pain. Have been to chiro. and I feel like it is worse. I decided to see a ortho/spine specialists. Couldn't even sit in his office. He ordered an MRI and I am to follow up tomm. From what I read it doesnt look good. Really, stressed. Supposed to go on Vacation with the family July 1. Heres my MRI
L2-L3----Central Annular Tear with shallow disc protrusion.
L3-L4----Development of a right paracentral disk protrusion. Moderate right central canal stenosis. impingement on right sided nerve roots in the lateral recess.
L4-L5----Central annular disk tear. Shallow right paracentral protrusion.

Impression: interval development of a large right paracentral disc protrusion at L4-L5. Moderate central canal stenosis. Impingement on nerve roots in the lateral recess right, greater than left.
I am praying for no surgery. Everyone tells me it doesn't look good. I really don't want to cancel my vacation July 1...arrgg..Can anyone tell me what this really reads. Thanks
Re: Ouch my Back!
Jun 10, 2012
Welcome to the board. The MRI is one piece of the diagnostic puzzle. The spine specialist will correlate it to what he/she finds upon physical examination, a basic neurologic exam and what you report regarding symptoms, levels, type and location of pain to reach a diagnosis.

The report indicates you have some problems with three lumbar discs located between the pairs of vertebrae at L2-L3, L3-L4 and L4-L5. The discs are the "cushions" that separate the bony vertebrae. They are subject to life's wear and tear, to drying out and to aging.

At L2-L3 and L4-L5, you have annular tears that are centrally located. An annular tear occurs when the tough, outer ring of the discs tears. This can allow some of the disc material to leak out which can result in a nerve compression or a chemical irritation of the nerve. At these levels there are small disc bulges.

The more significant problem appears to be at L3-L4 where the writer indicates there is some nerve involvement. At this level, the disc is also bulging, and it is pushing out to the right of center. The writer mentions moderate central canal stenosis. Central canal refers to what we think of as the location of the spinal cord...which ends at the L1 level. After this point, the nerves bundle together to form the "cauda equina" which is contained within a thick tube-like sac. This is the main highway for the nerve signals that run up to the brain and back down and signal movement and sensory messages to the nerves that fan out from the central canal. Whe.n "something" presses into the thecal sac it can have an effect on the nerves contained within the sac.

In your case, the central canal itself is narrowing. Since the nerves need a specific amount of space to function, when the sac containing the nerves is narrowing, it can result in nerve compression. This is what often causes what we think of as "sciatic" pain -- the pain that runs down the buttock and into the leg...and is somewhat relieved by bending forward, like leaning on a shopping cart when walking. (This opens up the space in the central canal enough to relieve the pressure on the nerves.)

The degree of stenosis is rated in radiology language. The least amount is referred to as minimal. Then the rankings are: mild, moderate and severe.

Compared to many of the reports we see on the board, yours doesn't send up any red flags. Your doctor will most likely recommend conservative treatment modalities such as oral medication for pain, NSAIDS for inflammation, a course of physical therapy, and perhaps a series of epidural steroid injections. Unless you have bladder or bowel involvement or a sudden loss of muscle strength, surgery would not be recommended until conservative measures are tried and fail.

Bulging discs can and do heal without surgical intervention. Through conditioning the muscles of the core and back, you may be able to conteract the effects of the stenosis.

I don't know what type of trip you are planning, but unless your pain prevents you from participating, I see no reason why you couldn't go with your family on the vacation.

The thing about lumbar injuries is that they not life-threatening and they are rarely a medical emergency (unless there is bladder or bowel incontinence, etc.). They may cause an immense amount of pain, but they do not damage your health.

Please allow your doctor to explain the MRI to you. As you mentioned, we are not doctors and only try to explain the language of the report so you will have a better idea of what the doctor may discuss with you.

Please let us know what the doctor suggests for treatment and give us an update on your condition.

Do you have any leg pain on the front of your thigh or along the side?

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