Question
I have been in and out of work for almost two years from a job related car accident. The doctors that I have been going to seem not to care. I, with the help from god survived a horrible car crash. When I was at the hospital I told the emergency room people of knee, back and neck pain. The did some quick x-rays and a cat scan of my brain (because of concussion) then told me to go back to work in two days.I could not even remember what happened or who came to the hospital) I have been having short term memory problems everyday since this accident. Well after some fighting with people my wife got workman's comp to approve a meeting with a doctor. He was a spinal specialist who only took X-rays and said everything was fine and told me to go to physical therapy. After 3 days of physical therapy my back and neck got worse. I was having numbness and tingling in both legs as well as down both arms. After fighting with workmen comp for weeks I was allowed a second opinion. He did MRI's of my neck and back. The radiologists report said there was nothing wrong. When the doctor read the films he noticed two bulging discs in my neck and one in my lower back. He then recommended injections for my back and neck. I did the injections with no relief. He then sent me back to work on light duty. Driving and sitting for more than 20 minutes hurt my lower back so much that I had to stop and stand. Even while standing for 20 minutes or so my back started hurting more. I have been on several pain medications (percocet, Roxicodone, Kadian) that give some relief to the stabbing pains but do nothing for the chronic pain. My latest MRI of my lower back shows this result.

Level L4-L5 disc bilge and central herniation is demonstrated which effaces the ventral aspect of the thecal sac. The neural foramina are patent.

I have not had a new MRI on my neck yet. I also have severe pain between my shoulder blades that radiates down my arms. I asked the doctor if I should have an MRI of the middle of my back and he said that if there were any problems there you would be paralyzed and since I wasn't there is no need to do an MRI there.

My main questions are what does the MRI of my lower back mean. I do not understand and the doctor wont explain it to me. Also could there be damage to the middle part of my back without being paralyzed. Also could a spinal cord injury effect my memory.

Sorry it was so long but needed to give you an idea of what has transpired over these long painful two years.
Thank you  

Answer
Hi Jeffrey-
A bit of anatomy first:  your spinal column is made of bone-y pieces called vertebrae, the things you can feel on the back of your neck.  In between these are discs, fluid-filled pieces that cushion the vertebrae and keep them from crunching together.  There is a hollow spot through all those bone-y parts that your spinal cord travels through, and between the vertebrae bunches of nerves travel out to your arms, legs, etc.  This whole thing is in a plastic-baggy sort of sac, and the fluid inside it circulates around your brain and spinal column.

Make sense?

L4-5 are the names of the vertebrae just above your tailbone, and a disc bulge there (as stated on the MRI) seems to be pushing against the cord and/or sac.  This is why you feel pain, numbness, or tingling that shoots down your legs ("effaces" means it is rubbing against).  The foramina is the hollow spot through which nerves/cord travels, and it is good that they are patent (just means they seem intact and ok).  

There certainly can be damage to the middle of your back without paralysis- a similar herniation or bulging disc could be causing problems there.  My best recommendation to you is to get a better doctor!  One who will listen and explain what is happening and what your options are, because it is your life and happiness that are being affected.  I know finances sometimes dictate who you can see, but there are good doctors out there and it is worth your while to find one!
As far as treatment goes, the injections the one doctor did are usually the first step.  And because you had no relief the first time doesn't always mean there won't be relief the second time...  It is variable, but often they will try a second round of shots before giving up on it.

Memory loss- the concussion you mentioned could well have left you a memory gap.  It is not uncommon, and as long as you are able to make new memories since then it is likely not going to give you further problems.  It is disconcerting, though, I know!  

SO, i highly recommend going to a doctor you trust.  There may be solutions to these problems, and I am very hopeful for you to find them.  Don't give up yet, though I know being in constant pain is very tiring.  Please ask again if you think of more questions, or if I have skipped something .  In the meantime, I wish you the best of luck!

Leslie