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Had an MRI c and s contrast for lumbar pain. What are the findings?

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Spine Surgeon
Practicing since : 2002
Answered : 322 Questions
hi I t had an MRi c and s contrast for lumbar pain. 18 yrs ago I had an L5S1 discectomy. My MRI results read
L1-L5: Normal (this I understand.

Then it says
L5-S1 moderated to severe disc space and height loss, moderate degenerative endplate signal change. (this I do not understand) Mild diffuse disc bulging and minimal retrolisthesis of L5 relative to S1 ( my understand is diffuse being, bulging 360 degree around where it should be, but not herniating up or down. and retrolisthesis out of place in alignment for S1 alignment.) no evidence of spinal of stenosis or recurrent disc. there are postoperative findings on the right. What is meant by "post operative findings?

then it states no abnormal enhancement, or abnormality of conus. para spinal tissues are normal.

impression post operative findings on the right. there are disc and endplate degenerative changes at L5 S1

I am a nurse so you don't have to use basics. Also, what is the standard treatment for this as it already had a discectomy.

Thank you,
Posted Fri, 21 Jun 2013 in Back Pain
Answered by Dr. Rahul D Chaudhari 9 hours later
Thanks for writing to us.
You have degenerative changes at L5S1. Post operative changes mean laminotomy with fibrous tissue formation on rt side.
L5 S1 level disc height reduced with end plate changes which may be reason for lumbar pain? Do they mentioned about foraminal stenosis?
How bad is the pain? Affecting your routine? In that case you may need L5 S1 fusion. If possible please upload xray and mri. Thanks.
Above answer was peer-reviewed by
Follow-up: Had an MRI c and s contrast for lumbar pain. What are the findings? 11 hours later
Negative for stenosis, foraminal normal. Daily activities for the first 2 hours are excruciating and takes about an hour to feel my feet after waking, 3 hours for my back to ease even with vicodin 7.5/500, voltoren gel, and a XXXXXXX it is agony. stride is half what it used to be do to pain. sitting too long, standing more than 20 minutes or sitting in a chair where butt is lower than knees is excruciating. I often need the head board to help me roll over in the morning to get out of bed. on a pain scale1-10 first thing in morning I am a 9,I force myself to move to walk even if its five step steps and then sit down again leaning forward. as the day progresses if I stay moving I am an 6-7 on pain meds, at night right back 9. getting up from standing and using stirs my R leg shakes.
Laying on my stomach causes instant searing pain, increased numbness and

All images I posted are up loaded under reports side view of MRIs c and s contrast, and xray s c oblique's.
pain is bilateral but more prominent on the R side, numbness is inner thigh, down inner calf, and thigh. and the bottom and top of my feet,
Answered by Dr. Rahul D Chaudhari 5 hours later
You have L5 S1 disc prolapse with reduced disc height. End plates are showing signal intensity which may indicate subtle instability. This is the reason for back pain.
when height is reduced then the nerve root tend to pinch in the foramen. If you have tried conservative trial like medicine and physical therapy with not much relief then you are a surgical candidate.
I would suggest to consider L5 S1 fusion with interbody spacer to maintain the disc height.
If you dont have leg complaints then you can consider doing Disc replacement surgery.
Above answer was peer-reviewed by
Follow-up: Had an MRI c and s contrast for lumbar pain. What are the findings? 5 hours later
When I went to physical therapy for evaluation, at he end he said he couldn't help me he felt I needed an orthopedic and an MRI.

I don't feel I am artificial disc candidate as hurt my legs have weakness.
would steroid injections help at all?
Answered by Dr. Rahul D Chaudhari 5 hours later
It would help for leg pain but may not help for back pain. You can definitely try for steroid injection. Thanks.
Above answer was peer-reviewed by
Follow-up: Had an MRI c and s contrast for lumbar pain. What are the findings? 2 days later
I am aware there is artificial discs, however given I am young how long do they last ( I know there no set time. However, I read that it is difficult to treat when they go bad due to scar tissue around the spinal cord). Also, I heard of butterfly spacers. Not familiar with this one, given this portion of the of the back bears most of the weight would it be a viable option, or does the same problem apply with wear and tear and scar tissue. Forgive me, I am a nurse in family practice. Also, my mother suffered from OPLL in her hey never discovered what caused her OPLL as it is mostly found in oriental heritage and we do not have that demographic in our family.

What is the standard recovery time for a fusion?

Thank you, XXXXXXX
Answered by Dr. Rahul D Chaudhari 17 hours later
If you have leg pain then you should consider fusion. Disc replacement is not an option for you.
Disc replacement may last up to 10 yrs with current data. However if you have familial tendency for excess bone formation then disc replacement level will fuse eventually.
Recovery after fusion is usually 6-8 weeks. Thanks.
Above answer was peer-reviewed by
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