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What Does This MRI Report Of Lumbar Spine Regarding Painful Lower Limbs Indicate?

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Posted on Thu, 12 Jun 2014
Question: This is an MRI report of my lumbar spine. I've had years of pain that is getting worse. Need a cane to walk. Left leg is weak with muscle atrophy in calf/ankle. I also have severe degeneration in my left hip and SI joints are now showing degeneration. I have family members that have/had ankylosing spondylitis. I've also been diagnosed with RA. MRI report: Impression - Mild levoscoliosis of the lower lumbar spine. Moderate to severe facet arthropathy L4-L5 with minimal anterolisthesis at the L4-5 level. Severe disc degeneration and moderate spondylosis at the L5-S1 level. Moderate central acquired spinal canal stenosis at the L4-5 level with thickened ligamentum flava. Foraminal narrowing is due to spondylitic ridging worse on the left. Mild annular bulge at the L2-3 level with no canal stenosis. Tarlov cyst at S3. A neurosurgeon told me basically that my lower spine has collapsed. His treatment was to give me injections. I declined. What do you think?
doctor
Answered by Dr. Indu Kumar (5 hours later)
Brief Answer:
You should go for injections.

Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM

Sorry to know about your suffering.
You are suffering from severe degenerative changes in lumbar spine.Your nerves are also involved and it leads to pain and weakness in lower limbs.

You doctor has rightly suggested for injections.It is injected near the neural foramen through which nerve roots exit.It causes decrease in pain and nerve roots inflammation.
You should go for it.Injections are given C-arm guidance and it is very precisely located.It is given as day care basis and patients are discharged on the same day.It is almost painless.
You can start physiotherapy after relieving from pain.

If pain persists then you can go for endoscopic surgery.These are minimum invasive procedures and in this procedure bony overgrowths are removed
that causes compression over the nerves.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (20 hours later)
Can the severe facet arthropathy start fusing together?
doctor
Answered by Dr. Indu Kumar (7 hours later)
Brief Answer:
Yes,it can fuse.

Detailed Answer:
Hello XXXXXXX
Thanks for writing back

Yes,facet joints may get fuse in severe arthropathy.
Facet joints are coated with cartilage and synovial membrane that secretes lubricating fluid.These coatings keep spinal movement smooth.
When facet joint arthropathy occurs,cartilage begins to wear away from the facet joints.This forces the bony vertebrae to make direct contact with one another and it makes any movement of the joint stiff and painful.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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What Does This MRI Report Of Lumbar Spine Regarding Painful Lower Limbs Indicate?

Brief Answer: You should go for injections. Detailed Answer: Hello XXXXXXX Thanks for writing to HCM Sorry to know about your suffering. You are suffering from severe degenerative changes in lumbar spine.Your nerves are also involved and it leads to pain and weakness in lower limbs. You doctor has rightly suggested for injections.It is injected near the neural foramen through which nerve roots exit.It causes decrease in pain and nerve roots inflammation. You should go for it.Injections are given C-arm guidance and it is very precisely located.It is given as day care basis and patients are discharged on the same day.It is almost painless. You can start physiotherapy after relieving from pain. If pain persists then you can go for endoscopic surgery.These are minimum invasive procedures and in this procedure bony overgrowths are removed that causes compression over the nerves. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX