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What does the following MRI report indicate?

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Posted on Wed, 20 Jul 2016
Question: My MRI shows
retrolisthesis of L1 on L2 3 mm
retrolisthesis of L2 on L3 5 mm
disk bulge L3-4 with AP 11 in the midline-mild bilateral formaminal
diffuse facet hypertrophy L4-5 and L5-S1
anterolisthesis of L4 on L5 8mm, 10 m with flexion
(my MRI in 2011 was close to the same and I did not have pain for 5 years)

Pain started when I was sitting at work (started work full time 2 weeks before)
I thought it was my sacrum moving out of place because I have been diagnosed with si joint (sacrum moving) for 10 years.

Therapist was treating me for SI joint problem; doing some thrust technigue and suddenly right when I left therapy pain was crazy bad. I had lighting bolt shocks down both legs, weak legs, throbbing pain at sacrum area and upper back pain and I lost control of bladder when I was in bed (this only happened 1 time the day after injury). I took 1 pack of steroids and pretty much did nothing for 2 months, then I went to 3 different physical therapist and deep tissue massage for 5 months. I have strenghtened my core and have been doing exercises for back but I still cannot sit down for 2 minutes without feeling bone aching pain even with a back brace. I do not sit except to drive to work which is 1/2 block from my house. I can not go out to dinner or sit to eat or put on make up. I had an MRI of my sacrum because this is where I feel the pain. The MRI showed everything was good. I have been to 2 surgeons who after looking at my MRI say I am unstable. Could the anterolisthesis of L4 on L5 cause pain this aching pain low in my sacrum when I sit. It feels broken when I sit and if I ignore pain and sit for a few minutes I feel increasing aching bone pain for hours. I can not live with this pain when I sit. I feel surgery is the only option. I can walk and do things around the house with some pain but its only when I sit that I feel this severe bad aching pain. Every time I tried to sit in the last 9 months I feel the pain in sacrum and in middle of back. I am afraid the Dr.'s and I are talking about 2 different things and they fix my spine but my sacrum still hurts. I don't know what other test can be done but I have to do something soon, I need paid relief.
doctor
Answered by Dr. Tushar Kanti Biswas (13 hours later)
Brief Answer:
Retrolisthesis & anterolisthesis of lumbar vertebrae with root compression

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Retrolisthesis of L1 on L2 and of L2 on L3 and disk bulge of L3-4 are causing varying degree of nerve root compression at different levels and also you had some degree of Spinal cord compression (loss of bladder control) which was relieved with steroids.
Initially, nonoperative treatment (physiotherapy, deep tissue massage,analgesics) is recommended, and most patients will have relief. Those with persistent pain or recurrent pain should undergo spinal fixation,disc removal as deemed appropriate.
The underlying disease could be spondyloarthritidis as you have also sacroiliitis;testing for serum HLA B27 is recommended,if not undergone already.
Please upload all the investigations you have already undergone,if possible.







Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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Answered by
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Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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What does the following MRI report indicate?

Brief Answer: Retrolisthesis & anterolisthesis of lumbar vertebrae with root compression Detailed Answer: Hi, Thank you for your query. I can understand your concerns. Retrolisthesis of L1 on L2 and of L2 on L3 and disk bulge of L3-4 are causing varying degree of nerve root compression at different levels and also you had some degree of Spinal cord compression (loss of bladder control) which was relieved with steroids. Initially, nonoperative treatment (physiotherapy, deep tissue massage,analgesics) is recommended, and most patients will have relief. Those with persistent pain or recurrent pain should undergo spinal fixation,disc removal as deemed appropriate. The underlying disease could be spondyloarthritidis as you have also sacroiliitis;testing for serum HLA B27 is recommended,if not undergone already. Please upload all the investigations you have already undergone,if possible. Regards Dr. T.K. Biswas M.D. XXXXXXX