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Help me translate my MRI results

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Hey all

I have an appt with my physio therapist and doctor next week to go over my MRI results but was hoping I might be able to get some help translating this in the mean time to appease my curiousity. Here goes...

'There is appr. 3-4 mm of retrolisthesis of the lumbar spine at L5-S1. The vertebrae heights are normal.

The conus medullaris is unremarkable in appearance.

There is moderate disc height loss at L5-S1. A large central to left lateral recess disc extrusion is present with appr. dimensions of 19 mm (ML) x 8.5 mm (CC) x 18.8 mm (CC). The disc extrusion contacts and probably compresses the traversing left S1 nerve root.

The Remainder of the lumber spine is within normal limits.

IMPRESSION

A large disc extrusion is identified at L5-S1. The disc extrusion contacts and probably compresses the traversing left S1 nerve root.'

I have a basic idea of what it says but would like your thoughts as well.

Thanks so much!

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Posted · Report post

I have almost this exact injury. I don't have dimensions of my extreusion though it is central and broad.

A disc extrusion is when the nucleus pulposus(central material) extrudes out of the annulas(a ligament I think). S1 nerve root compression can result in neurological symptoms such as numbness, tingling,or weakness on one or both sides accompanied with sciatica along the dermatome. Extreme cases may cause cauda equina which afftects bowel and bladder control and is a medical emergency.

Treatment is usually physical therapy and anti-inflammatories followed with more invasive procedures such as epidural steroid injections and finally surgery.

Good luck to you. I'm curious what symptoms you are experiencing?

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Posted · Report post

I have almost this exact injury. I don't have dimensions of my extreusion though it is central and broad.

A disc extrusion is when the nucleus pulposus(central material) extrudes out of the annulas(a ligament I think). S1 nerve root compression can result in neurological symptoms such as numbness, tingling,or weakness on one or both sides accompanied with sciatica along the dermatome. Extreme cases may cause cauda equina which afftects bowel and bladder control and is a medical emergency.

Treatment is usually physical therapy and anti-inflammatories followed with more invasive procedures such as epidural steroid injections and finally surgery.

Good luck to you. I'm curious what symptoms you are experiencing?

I have been off work for going on 5 months now with lower back soreness/pain, cold numbness/pins and needles intermittently going down the left leg. I have major difficulty bending over. I have lost full range of motion in my left leg but can still walk and get around with out a limp unless I have a flair up. I can't sit for any extended period of time. It easily flairs up. Apparently my symptoms according to a specialist I saw a few weeks ago are not severe enough for surgery although I am showing only minimal improvement with Physiotherapy, Chiropractor and Massage. I have improved enough to return to the gym to do a strict, short and light work out twice a week though... I wonder if I can eventually return to work with a herniation this large…

I saw your one post. How are your treatments going? I can not remember exactly what you said you where having done though.

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I returned to work 3 months ago but am occasionally still in severe pain. I tried chiropractor, acupuncture 2 steroid injections, and 2 moths of physical therapy with little improvement. I am having a micdrodiscectomy in 10 days to remove the herniation.

My symptoms are tingling and pain along with a dull feeling in my thigh and severe lower back pain. I have a hard time with bending.

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My ex-husband had an injury similar to this. His came from twisting while lifting a soil density gage. He ended up with a diskectomy and was placed on a 20-30 lbs lift restriction. He, then, pulled a "brainless" and jumped off a platform that was 6 feet in the air. He re-extruded the L5-S1 disk and ended up with compression fx of the L3 & L4 vertebrae.

You will have to work hard to overcome the injury and strengthen your back to be able to return to work without further complication. Start with the exercises that you have been given and work with a therapist to build and strengthen.

Good luck!

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So I got a call from my nurse practitioner today and she said the same thing as my chiropractor did. I have a 19 mm extrusion at L5 S1. This to me seems huge! Esp since the other day i told a doctor in passing I had a 12 mm bulged disc and his jaw almost hit the ground. Imagine what he would think of 19! I can not even seem to google this size. She will be talking to the specialist I saw and the doctor and I am most likely going to be referred to a specialist in the city.

Needless to say I am even more worried now. Scared of what is to come.

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Well let us know what you find out. My surgery is November 12th. I was scared but I am just ready to be out of pain. Good luck!

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Thanks medicgirl! Good luck to you as well. I see you are into horses. So am I. Have not been able to ride though so my 2 are hay burners for the time being.

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I do not have much to offer in the way of advice as it's generally good to avoid giving out anything that could be considered medical advice. However, back pain and the neurological issues associated with injuries and degenerative disease vary significantly from person to person. I had a "massive" herniation in my lumbar spine and also have spinal stenosis and spondylitis. However, in spite of an MRI that looks exceptionally ugly, I was able to recover with conservative, non-pharmacological therapy and go on to my current state where I have a good quality of life and manageable discomfort. However, someone with a much less dramatic MRI may experience significant pain and neurological impairment.

Good luck, but don't flatter yourself based on numbers. Everybody is different and people respond to different treatments in very different ways, especially when it comes to back pain.

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I do not have much to offer in the way of advice as it's generally good to avoid giving out anything that could be considered medical advice. However, back pain and the neurological issues associated with injuries and degenerative disease vary significantly from person to person. I had a "massive" herniation in my lumbar spine and also have spinal stenosis and spondylitis. However, in spite of an MRI that looks exceptionally ugly, I was able to recover with conservative, non-pharmacological therapy and go on to my current state where I have a good quality of life and manageable discomfort. However, someone with a much less dramatic MRI may experience significant pain and neurological impairment.

Good luck, but don't flatter yourself based on numbers. Everybody is different and people respond to different treatments in very different ways, especially when it comes to back pain.

How long did it take you to come back? Are you still doing what you where doing before?

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I deal with pain most every day, but it's manageable. I am not doing what I was before, but my daily activities are pretty close to what I did. Unfortunately, these thing do not magically heal, but rather slowly get better with good and bad days. I've accepted that I will probably never be in my 20's, but still have a great quality of life. It's been over three years and I think this is probably as good as I am going to get barring a medical breakthrough. Individual mileage will vary.

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I have seen my nurse practitioner, physiotherapist and my chiropractor now. I guess I have been focusing on the wrong thing on my MRI. 'Extrusion' is what I should be looking at. A tear in the fibrous outter tissue of a disc that has caused the gelatinous inner substance of the disc to leak out. I have been signed off work until I have seen an orthopedic surgeon in the city for a consult to see if I continue intense therapy or do surgery. Until I can get in to see him my physiotherapy has been bumped up and intensified. Wish me luck and thank you for all your input. It has helped me greatly. I appreciate it. I will keep you posted on what happens.

Medicgirl… 6 days to go. Let me know how it goes.

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Does anybody know anything about Doctor Joel Finkelstein at Sunnybrooke? Good guy?

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Yes, the extrusion is what I've been told is more the cause of the pain than the herniation. Apparently the tear allows the chemicals to mix with those outside of the disc resulting in pain. It is unlikely that the microdiscectomy will fix my back pain, though it should help with the leg pain and tingling. I will be curious to know how you are treated. Good luck!

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Well, my surgery was 5 days ago and I already feel much better! I woke up with unbearable muscle spasms in the recovery room, but those were relieved in recovery with meds. My surgery was at 8AM and I left the hospital around 2PM. The first 2 days weren't great and I stayed medicated and slept most of the time. Today was the first day that I felt good enough to leave my house. I have been walking without pain since day one. My numbness and tingling were completely gone when I woke up and have stayed gone. My problems now are that I can't sit for more than about 15 minutes without starting to hurt, which is normal. Also, I have some tightness around the incision probably cause by swelling of the tissues. All in all I am very happy with the sugery and anticipate a quick recovery.

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I am very happy for you medicgirl. You are far too young to be saddled with a chronic back problem and I am really glad the surgery went well.

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I am so glad your surgery seems to be working so far!! So it is looking good for you to return to work then? How long of a recovery time will you need? I am waiting for a call back from an orthopaedic surgeon. Looks like I will be following suite. Keep posting on your recovery! Very interested and so relieved that you are doing so much better!

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Well my surgery was a little over two weeks ago, I'm not so sure I am happy anymore. A brief summary, some of my symptoms are gone...but some are much worse. I no longer have tingling, but I can't sit more than 15 minutes without pain in my butt. My doctor is about 3 hours away and after the trip up there and back Monday I was miserable!!! We stopped multiple times so I could walk, but the pain was almost unbearable when I got home. I was told before surgery that I could go back to work after 4 weeks with no questions, now the surgeon says he doesn't even allow people to start physical therapy until 6 weeks after surgery. I'm so upset after seeing th surgeon for my follow-up. He also said that is could take up to a year for the lingering symptoms to get better, I was under the impression it would just take a few weeks, or maybe a month.

I hope you have a better experience and be sure you go in knowing what you are getting into, I obviously didn't. I plan on writing a blog because there are even more issues but I can't sit here any longer. I have a new understanding of back pain these days!

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Oh no! Thats awful! I read that it takes 3 months to recover fully but never heard the 1 yr thing. That worries me. I only have 2 yrs on my leave and I have a year wait to see the surgeon (and I am 7 months in already!). I am even more scared then ever to take that route! I probably already know this but I must ask again. Did an orthopaedic surgeon do yours or did a neurosurgeon? My pain seems to be easing slightly in the sense that when I tweak my back it seems to recover a bit faster. I am wondering if it has to do with my core strength coming back. If your back is like this now is there still hope of your return to work? If you start a blog then give me the address. I will follow it.

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Well my situation has improved at this point. I saw the surgeon(orthopedic spine specialist) again. I am going back to work tomorrow. This past week has been awesome. No pain or tingling. Apparently that was somewhat normal. They expect the first week after surgery to be good, then the nerve usually has some swelling the second week which calms down weeks 3 & 4. My case is being rushed a little because if I don't go back to work tomorrow I will lose my job. They usually require 6 weeks of no bending, lifting, or twisting but I am going back to work with a lumbar corset. The worst that can happen is I can reherniate the disc which is likely regardless when I go back.

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Well my situation has improved at this point. I saw the surgeon(orthopedic spine specialist) again. I am going back to work tomorrow. This past week has been awesome. No pain or tingling. Apparently that was somewhat normal. They expect the first week after surgery to be good, then the nerve usually has some swelling the second week which calms down weeks 3 & 4. My case is being rushed a little because if I don't go back to work tomorrow I will lose my job. They usually require 6 weeks of no bending, lifting, or twisting but I am going back to work with a lumbar corset. The worst that can happen is I can reherniate the disc which is likely regardless when I go back.

Take care of yourself girl. You can always get another job but your health is priceless.

Best wishes.

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You will lose your job?! Thats crazy. My work is required to hold mine for at least 2 yrs and even then if I am able to return then they will hold it even longer! Be very very careful. You only get one back in life. You muck up your back even worse and you won't be able to go back to your job. So very happy that you are feeling better though. Gives me hope that I will get over my roller coaster ride of a back injury someday soon.

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So I got a call from my doctor who said that I have been given priority 1 status although even with that status it can still be up to a 12 month wait to get in. My back is no better and I only have 2 yrs leave from work. I hope they are much quicker then a year. Welcome to Canada where the healthcare is mainly free but the wait to get in to see a doctor is LONG!! Grrrr

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