Question: XXXXXXX male 38 yrs old - motorcycle accident - flipped end over end - could not move right after injury - took 2 weeks before could walk without assistance - had MRI 8/31/2012 - this is the report summary: There are bilateral
pars interarticularis defects of L5. There is significant 8 MM anterolisthesis of L5 relative to S1 and 5 MM anterior subluxation of L5 relative of L4. The bilateral pars interarticularis defects to preclude centeral canal stenosis.
A. At l4-5, there is a moderate-sized posterior central and left paracentral disc extrusion, which migrates inferiorly behind the upper half of the L5 vertebral body, imping the left L5
nerve root in the left lateral recess, that, my opinion, has a significant likelihood of being clinically relevant. Part of the extruded disc fragment contains high water signal and can be seen for instance on axial T2 sequence Image #12
B. At L5-S1, there is uncovered extruded disc material extending just slightly superiorly behind the inferior endplate of L5, attenuating fat in the anterior epidural space, abutting tyhe traversing S1 nerve root in the lateral recesses. However, more significantly, extruded disc material extends intraforaminally, bilaterally, right greater than left, up toward the infrapedicualr axillae, with potential impingement on either exiting L5 nerve root. -
he than fell out of a tree while trying to work - landed on his feet - pain - got xray on 6/30/2013 following report; A single view of pelvis was performed. AP and lateral views of the
lumbar spine were performed as well as spot view of lumbosacral junction. Examination demonstrates a
spina bifida occulta. There appears to be a pars defect aat L5 with
spondylolisthesis similar to that seen on prior MRI exam. No new fractures are seen. Mild narowwing is seen at L5-S1.
Facet disease is seen at L5. Had seen Dr at pain mgmt after accident - gave him Lortabs did nothing to help except cost a lot of money for office visits. unable to work without some type of pain meds. I am his mother and I am trying to get him help - need understanding of his injuries. He is an addict the was on Methodone - got him changed over to subutone for one week and then changing to subutex for nex 9 to 12 mos to overcome this problem. But I am concerned about his
back injury and his ability to do physical labor. Please advise. XXXXXXX