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I had a MRI lumbar spine w/o contrast and the findings are :

Routine MRI of the lumbar spine was performed using sagittal and axial imaging . incidental finding in the right pelvis shows a moderate amount of free fluid. the tip of the conus is seen at the L1-L2 level and appears normal.

L3-L4 shows some broad based buldge or protrusion causing some deformity of the anterior portion of the thecal sac. but no canal or foraminal stenosis.

L4-L5 shows posterior element thickening causing mild canal narrowing but no neural forminal stenosis .

L5-S1 shows posterior protrusion/herniation in a central and left paracentral location displacing the left S1 root and abutting and causing mild deformity of the right S1 root. with no neural foraminal stenosis noted.


I go to a neurologist Jan 17th, I am just trying to understand these results, So i know what to tell my Neurologist about my Family history and what questions to ask him.

My mother has Osteoarthritis and degenerated disc disease and my Grand-mother (mothers side) had same thing and alot more with her spine, also she had bone cancer in her lower spine and left her a paraplegic.all before the ages of 50 . I am 37 yrs old and i feel like i am 80 yrs old . I shouldnt be feeling this way and i certainly dont want to live off of pain meds for the rest of my life just so i can cope with it. I just recently became a Cert. nurse Asst. and I work in a Hospital, and i am on medical leave atm. because they can not accomadate my work restrictions. which is no lifting anything greater than 5-10 lbs, no bending, sharp turning, sqautting, sitting or standing for more than a hour w/o breaks . and that right there pretty much puts a big damper on my career ! because that is what I do 12 hrs a day . Anyways I am hoping to under stand these results a little better. so i know what to ask my Neuro doc when the times comes .... thank you ...
[QUOTE=twohands;5254331]Welcome to the boards, LadyBella, and I'm sorry to hear you're having such pain problems. Please know that you are in good company as far as dealing with chronic lumbar back pain.

From looking at your MRI radiologist report, I think the most concerning issue isn't your back, but rather the fluid build up in the right side of your pelvis. This isn't normal and something is causing this, and I believe it's urgent you get to the bottom of it quickly.

Who ordered your MRI? Was it your primary care doc? Whoever it was, I'd suggest you get them on the phone and be assertive about getting to the correct specialist within the next few days to have them order more tests (ultrasound or whatever) to find out what's going on. You need to be in control of your health, and sometimes that takes being almost demanding to get the proper care in a timely manner.

After you deal with the pelvic fluid issue, then you can work through your lumbar spine issues.

According to your MRI, you have spondylosis (a.k.a. wear-and-tear osteoarthritis) at a few levels. This can cause bone spurs (you don't have this yet apparently) as well as narrowing of the spinal canal and spinal canal exit areas - one at each level on each side where the nerve roots "peel" off and go out to the areas of your body that they serve.

L3-L4 and L5-S1 (the bottom disc level and the 3rd one up) have bulges/herniations. The worst one seems to be at L5-S1 (the bottom one) - "displacing the left S1 root and abutting and causing mild deformity of the right S1 root." This basically means the disc at your bottom level is protruding to the point where it is rubbing up against your S1 nerve root, and this can cause major pain. Some people experience this pain especially when they sit as that causes the disc to protrude out more and pinch the nerve with more force then.

You can think of your discs which are in between each level of your vertebrae like jelly donuts, but with a tough outer shell. This tough outer shell is almost like very tough grizzle, and the interior of each disc is filled with a caustic chemical jelly fluid. As we age or get injured, this tough outer shell can weaken or even burst. When you have a protrusion (herniation), the shell can either remain intact or it can tear and allow the caustic fluid inside the disc to leak onto your nerve roots which can cause major pain. The only good way to tell if a disc is torn all the way through is a test called a discogram which is only used if a major spine surgery is being contemplated. It may be very helpful in your case to determine which levels are pain generators for you so if you have surgery you are getting all the levels which are causing you pain.

Also, when the outer shell of a disc is protruding onto a nerve root, this can pinch the nerve root or sometimes serious irritation to it. Our bodies can sometimes reabsorb up to 50% of a herniated disc, but it can take years for that to happen.

You said you're going to a neurologist. They will basically try to determine if you have any chronic pinching or damage to one of your nerves. However, the tests they run like EMG's may not pick up irritated nerves or nerves that only get pinched in certain positions like sitting, so be aware of that.

If I were you, I'd get in to see a fellowship-trained orthopedic spine surgeon or neurosurgeon who only works on spines. What kind of doctor(s) have you been working with so far?

Best wishes![/QUOTE]

Thank you so much for responding back, I have only been to my family doctor who basically sent me to a Neurologist. Which I go Jan 17th. She put me on work restrictions and my work does not accomadate them . so now i am on medical leave. Basically I am not allowed to lift anything greater than 10lbs, no bending, sharp turns ,squatting, kneeling, no sitting or standing longer than an hour. i work in a hospital as a cert. nurse assistant. so that pretty much right there puts a huge damper on my career.

It started off with pain in my groin/pelvic bone area,up to hip and down right leg and tailbone and everytime i walked alot it stopped me in my tracts. because i would get a sharp pain. then one day i was getting ready for work and went to bend down to pick something up and my back went out, the pain was soooooo bad that i couldnt hold myself up my hips and tailbone felt like they were being torn from my body. i was actually getting nausiated from the pain. then my hubby rushed me to the er, which they gave me morphin and valuim i.v. waited an hour then sent me home with prescriptions and told me to get ahold of my doctor asap. so i did and then she ordered the MRI w/o contrast. the hopstial gave me muscle relaxers and lortabs but they didnt work, i had extra tramadol from a previous injury to my ankle. anyways i ended up taking one and it seems to take the pain away w/o me feeling like i was high as a kite. so my family doc prescribed me tramadol and that is what i am taking for the pain, I still get pain in my lower back , tailbone, and down my legs , also noticed new symptoms if i sit to long my spine feels compressed and the back of my neck starts to hurt and its been cracking alot lately too when i turn , it sounds nasty lol. ... also i get pains in my wrists and in both legs like a achey burning feeling in legs.

I have also noticed my height is shrinking, i use to be 5f3 , now i am maybe 5f1 in half . is that because of the discs ?

Am i gonna be disabled because of all this?

As far as the free fluid in pelvis, i do beleive it may be from a cyst i have on my right ovary, last time it was checked it was 2.5 - 3 cm in size . i did have a hysterectomy done about 4 or 5 yrs ago. because i had fibroid tumors and pre-cancer cells in my cervix. the doc left both my ovaries .

Again i thank you very much for responding to me !

"Am i gonna be disabled because of all this? "

None of us can answer this for you. We'd all love to have the crystal ball so we can live life on our terms and as we want, but sometimes life throws us a curve ball and we need to run with it.

When I was first injured 5.5 years ago, I kept seeking the surgery that would fix me and get me back to work, and ended up having 6 surgeries in the process (3 were due to complications from the 3 intended surgeries I had). For me, going back to a productive life of working full time again never happened. For many others, it has happened.

Once you have spine problems, you will never be like you were before your back was injured. However, it's still possible to live life to the fullest and enjoy every moment. Can you tell I'm an eternal optimist?

One thing I'll caution you about is that pain is a very strong motivator to have surgery. However, often times after surgery you won't be pain-free, but may have less pain. Don't sign on for having surgery before getting at least one 2nd opinion, and exhausting conservative measures first.

Also, I'd strongly suggest you have your primary care doc get you a referral to a spine surgeon in addition to just waiting and seeing a neurologist several weeks from now. There are conservative therapies you could be doing now such as cortisone injections and physical therapy that may bring you great relief, but it will usually be a spine surgeon you work with to get these treatments.

I ended up losing my job as I was no longer able to do the functions required, and it's necessary for you to take the proper steps now to avoid losing out on any short- or long-term disability you may be entitled to, as well as possibly SSDI if it ends up coming to that.

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