Question
I just had an MRI done and I am scheduled to see a Orthopedic Surgeon.  I'm really scared and I just wanted your opinion. I am 38 years old. I had an injury when I was 22 years old.  Within the first year that I injured my back went out all the time. But as the years went by I was fine, with an occasional episode.  But this year I have had four episodes, the last one resulting in a week without being able to work.  Still I am unable to perform all of my daily functions.  These are the MRI results:EXAMINATION: MRI of the Lumbar Spine Without Contrast
IMPRESSION: Multilevel degenerative changes with spinal canal stenosis and bilateral neural foraminal narrowing at L3-L4, L4-L5 and L5-S1.
CLINICAL INDICATION: Sciatica with lower back pain and numbness.
INTERPRETATION: Multisequence, multiplanar MR Imaging of the lumbar spine was performed without administration of intravenous contrast.
There is straightening of the normal lumbar lordosis. Vertebral body height is preserved The conus is normal in size and signal. The paraspinal soft tissues are unremarkable. There is desiccation of the L3-L4, L4-L5 and L5-S1 discs.
At L5-S 1, there is an annular tear. There is broad-based central disc protrusion. There is bilateral facet and ligamentum flavum hypertrophy. There is bilateral neural foraminal narrowing. There is bilateral lateral recess stenosis. There is mild to moderate spinal canal stenosis.
At L4-L5, there is broad-based disc protrusion with annular tear slightly to the left of center. There is bilateral facet and ligamentum flavum hypertrophy. There is bilateral neural foraminal narrowing.
There is mild to moderate spinal canal stenosis,
At L3-L4, there is broad-based central disc protrusion. There is annular tear. There is facet and ligamentum flavum hypertrophy. There is mild to moderate spinal canal stenosis.


Answer
Hi Judith,

The most important findings from your MRI results are the 'spinal canal stenosis and bilateral neural foraminal narrowing at L3-L4, L4-L5 and L5-S1'. Your spinal cord is surrounded by the bones of your spine. There are certain changes that have happened in the lower part of your spine that are decreasing the amount of space that your spinal cord has to pass through (spinal stenosis). This can lead to injury to your spinal cord because it is being compressed. Your results show that you have 'mild to moderate' spinal canal stenosis which means that your spinal cord is only a little bit compressed.

The nerves that go to your legs come from the lower part of your spine. When you have 'neural foraminal narrowing' that means that the nerves which are coming from your spinal cord have decreased space to travel through. Because the nerves cannot pass through smoothly, it leads to sciatica and other nerve problems such as numbness in your legs.

Your nerves and spinal cord need a clear path to move through and when you have degenerative changes (which may have resulted from your accident 16 years ago and progressed with time) it can affect the nerves, joints, and muscles in your back and legs leading to back pain, sciatica and potential weakness in the legs.

Because you have mild-moderate stenosis, your Orthopaedic surgeon may recommend that you try conservative therapy (Chiropractic, Physical therapy) or they may discuss surgical options with you.

With appropriate care many people who have MRI findings similar to yours go on to live a comfortable life without continuous pain.

I hope this helps!

Dr. Liza