Question
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Followup To
Question -
My mother recently had an MRI to find out why she is having severe pain in her left hip and neither of us understand the report.

The MRI report says:

There is mild disc desiccation and intervertebral disc space loss at the L5-S1 level.  At the level of L5-S1, there is a left paracentral disc herniation.  Increased signal is seen on the T2 sequence which indicates annular tear.  There is slight posterior displacement of the descending S1 nerve root on the left.  There is some mild facet hypertrophy and mild thickening of the ligamentrum flavum.

At the level of L4-L5 there is a diffuse concentric disc bulge.  There is mild facet hypertrophy.  There is mild thickening of the ligamentrum flavum.  At the level L3-L4 there is mild facet degenerative changes and mild thickening of the ligamentrum flavum.  

There is paracentral disc herniation at the level of L5-S1 with posterior displacement of the left S1 nerve root.

Can you please tell me what this means and if this is serious or not?  Also, would something like this require surgery?

Thank you,

Shannon Dunkel    
Answer -
MRIs are used to figure out the cause of clinical symptoms.  Many people have disk herniations and bulges with no symptoms at all.  A lot depends on a person's specific anatomy.  Some people have larger holes for structures to pass through so nerves never get pinched.

If your mom had symptoms like radiating pain down her leg, numbness, tingling or loss of bowel or bladder control this would be very significant and might warrant surgery to decompress the nerve.  A disk herniation is when the soft center of the disk squeezes out through a tear in the casing.  The report says that it has put enough pressure on the S1 nerve to move it, this may be important.  However, if symptoms aren't that bad your doctor may just want to watch and wait as most of these cases heal on their own.

The facet degeneration and ligament hypertrophy are related to wear and tear of the spine.

The best thing to do is ask your physican to answer your questions.

Sincerely-ajb

My mother, who is 52 years old, has pain radiating down into her leg and pelvic area, numbness, tingling, and burning.  My mother can not sit for more than 15 minutes without being in severe pain and she has to place a telephone book under her hip if she wants to drive some place.  My mother works as a housekeeper, so will she make her condition worse if she continues to work?  Thank you for all of your help, it really is appreciated.

Answer
This is really orthopedics and outside of my field so you'll have to discuss it with an orthropedic medical physician.

However, disk problems are worsened by weight bearing positions like sitting or lifting.  If the symptoms are worsening and she has progressive weakness of her leg muscles then she probably needs surgery to remove the disk.  If they aren't getting worse then your doctor may want to refer her to physical therapy for a trial of McKenzie exercises to see if that would control the symptoms (which it does in many cases).

Most likely the lifting involved in housekeeping is aggravating her problem.

ajb