Question
QUESTION: i need my lumbar spine mri explained please:

L4-5: combination of grade 1 spondylolisthesis and broad annular bulge causing marked right and moderate left foraminal narrowing and flattening of the anterior surface of the thecal sac.  

L5-S1: mild diffuse annular bulge causing deformity of the anterior surface of the thecal sac and sligjt impingement and posterior displacement of the left intrathecal s1 root.  extend of the annular bulging into the neural foramina cause moderate left and mild right faraminal narrowing.

also, what do you think the treatment will be??? im hoping epidurals...

ANSWER: Hi Tara,

A spondylolisthesis is a slippage of a bone forward. This is a grade 1, so it is slight. There is no mention of a spondylolysis, a break in the bone which allows it to slip forward, so I would assume the spondylolisthesis is degenerative.

The broad annular bulge is the outer part of the disc pushing outward. This is not a classic herniation, however, it can cause narrowing of the holes that the nerves (foramina) and/or spinal cord covering (thecal sac) goes through. That is the foraminal narrowing (nerve) and pressure on the thecal sac (spinal cord covering).

The narrowing of the foramina can cause, in addition to back pain, pain, tingling or numbness into the hip and possibly down the back of the thigh, side of leg and into the feet.

You can get a better view of these things at http://www.necksolutions.com/back-herniated-disc.html

The treatment depends on your symptoms and medical history. So, it is difficult to say what treatment would be tried. If conservative, you might have some physical therapy, perhaps a good chiropractor could help. They may go with injections as well. The thing to be aware of is if you have any numbness in the saddle region (where you sit), loss of bladder or bowel control, which would indicate surgery.

I hope this helps and that you get better very soon.

Regards,

Dr. Steve


---------- FOLLOW-UP ----------

QUESTION: Just wanted to thank you for your reply! I can understand!!! Haha also wanted to let you know that I have done all the conservative treatments available. I stretch constantly which helps, however it has made me very flexible over the years and because of this I am extremely hard to adjust. I still see a chiropractor regularly and take advantage of a decompression table too. I'm a hairdresser and have been having to use a chair (which I hate). Thanks again for your help and concern! I too hope I get some relief soon😊

Answer
Hi Tara,

I am glad it helped.

I think that the next step might be injections. Just keep in mind any warning signs as I stated. As long as you do not have any of these, you can exhaust all options prior to any type of surgery, providing you can deal with the pain and loss of function. One thing that might help you stand while you work is a traction belt to provide decompression while you stand. You can see it at http://www.necksolutions.com/traction-belt.html - not cheap, but is the real deal regarding these belts.

Anyway, I am happy to help any way I can and wish you all the very best.

Dr. Steve