MRI Lumbar Spine

[userabcd]

I am in my mid to lower 60's and about 3 weeks ago I developed pain in my lower back. I am located in Bangkok in Sukhumvit area.

 

About 10 days ago the pain in my lower back went away but was replaced by mild pain/aching in my left buttock and in the left side of my lower leg. The pain/aching started mild but gradually increased over some days and was affecting my walking. I have aching and pain  in my left buttock leg when lying down in any position. I have also developed pins needles in big toes and my left and right foot and in the ball of my right foot.

 

Standing or sitting alleviates most of the pain. 

 

An internet search indicated I may have sciatica so yesterday I went to have an MRI of my Lumbar spine and I have received the following result.

 

MRI OF THE LUMBAR SPINE
Clinical case of spinal stenosis.
TECHNIQUE : Axial/sagittal T1W, T2W and fat suppression T2W, coronal T1W,
MR myelogram
FINDINGS :
- The study reveals lumbar spondylosis, with degenerative changed of the intervertebral disc.
- Grade I anterior spondylolisthesis at L5/S1 level is seen, with spondylolysis of L5.
- L1/2 and L2/3 : Mild posterior bulging of the intervertebral disc is observed, causing mild
narrowing of the spinal canal and pressure effect to the thecal sac, without nerve root
compression.
- L3/4 : Posterior and posterolateral bulging of the intervertebral disc is also seen, causing
mild narrowing of the spinal canal, pressure effect to the thecal sac and narrow of both
exiting nerve root canals, without nerve root compression.
- L4/5 : Left posterior extrusion of the intervertebral disc is shown, causing moderate
narrowing of the spinal canal, pressure effect to the thecal sac and compression to the left
traversing nerve root of L5.
- L5/S1 : Mild narrow of disc space, posterior and posterolateral protrusion of the
intervertebral disc is noted, additional grade I anterior spondylolisthesis, causing mild
narrowing of the spinal canal, pressure effect to the thecal sac and compression to the both
exiting nerve roots of L5.
- Conus medullaris and SI joints appear normal.
- The otherwise are unremarkable.
IMPRESSION :
- Grade I anterior spondylolisthesis at L5/S1 level, with spondylolysis of L5.
- L4/5 : Left posterior extrusion of the intervertebral disc, causing moderate narrowing of the
spinal canal, pressure effect to the thecal sac and compression to the left traversing nerve
root of L5.
- L5/S1 : Mild narrow of disc space, posterior and posterolateral protrusion of the
intervertebral disc, additional grade I anterior spondylolisthesis, causing mild narrowing of
the spinal canal, pressure effect to the thecal sac and compression to the both exiting nerve
roots of L5.

 

When I read the doctors report my condition seems serious.

 

My query is if serious I would appreciate help and advice for a doctor to treat and advise me.

 

 

[wprime]

I hate to break bad news to you, but from the MRI report, it looks like you've got a bad case of getting older.

 

Degenerative changes happen to all of us so  I wouldn't worry about that, but you do have some nerve compression which would explain your symptoms. It's not a medical emergency but you should talk to a doctor about that, it can often be symptomatically resolved with physical therapy or medication and there are surgical interventions which you might be interested in depending on your level of pain.

[scubascuba3]

Have a look on YouTube for sciatica treatment, sometimes can find some videos that really help, certain stretches will help maybe it will go away. My back issues come and go, part of life

[86Tiger]

 

 

I recommend Mark Leoni in Bangkok.  He helped me in past.

[covidiot]

daily walks may be helpful for lower back pain. 

[Sheryl]

The report suggests nerve root compression, as do your symptoms.

 

The reports that accompany MRIs are not done by spinal specialists and until one has looked at the film, should be taken with a grain of salt. A good spinal specialist will ignore the report, read the film himself (make sure you have the CD) and correlate that to the findings on clinical exam.  In some cases nerve conduction studies may also be done, especially if surgery is contemplated, in order to be sure the cause of the pain is as suspected. (Sometimes the MRI findings are purely incidental.)

 

See Prof. Wicharn at either BNH Hospital. Be sure to bring the actual CD of the MRI with you.  And Xray if you had one, if not he may order one.

 

https://www.bnhhospital.com/find-doctor/search-result/?dname=Wicharn

 

Do not delay, the pins and needles in your feet suggest nerve compression which needs to be relieved to avoid permanent nerve damage.

 

 

 

 

 

 

[userabcd]

12 minutes ago, Sheryl said:

The report suggests nerve root compression, as do your symptoms.

 

The reports that accompany MRIs are not done by spinal specialists and until one has looked at the film, should be taken with a grain of salt. A good spinal specialist will ignore the report, read the film himself (make sure you have the CD) and correlate that to the findings on clinical exam.  In some cases nerve conduction studies may also be done, especially if surgery is contemplated, in order to be sure the cause of the pain is as suspected. (Sometimes the MRI findings are purely incidental.)

 

See Prof. Wicharn at either BNH Hospital. Be sure to bring the actual CD of the MRI with you.  And Xray if you had one, if not he may order one.

 

https://www.bnhhospital.com/find-doctor/search-result/?dname=Wicharn

 

Do not delay, the pins and needles in your feet suggest nerve compression which needs to be relieved to avoid permanent nerve damage.

 

 

 

 

 

 

OK thanks a lot Sheryl, this is exactly the advice I was looking for.

 

I did not get the CD so will have to go back to the MRI clinic to get the information, all they have sent to me so far is this report.

 

Tomorrow I will make an appointment to see Prof Wicharn.

[orchidlady]

I sent you a private message

[arjunadawn]

Many people evidence various disc issues on MRI. However, you are symptomatic- and at multiple levels. L5 compressing bilaterally is much less common than one side. You need to see orthopod and determine confidently which is your primary pain generator. Bulging discs are not uncommon. Nerve root compression- bilaterally- is! My last spinal fusion was an OLIF procedure at BKK Hospital, BKK spine center. This does not mean you require this, only that it solved my problem- similar. I wish you well. 

[Led Lolly Yellow Lolly]

On 5/5/2021 at 7:22 PM, Sheryl said:

Do not delay, the pins and needles in your feet suggest nerve compression which needs to be relieved to avoid permanent nerve damage.

 

Ditto that. @userabcd I ignored pain in my upper back, shoulders and neck for over a decade because multiple successive doctors failed to give me a proper diagnosis, until it got so bad I wound up on IV Tramadol at my social security hospital. Turns out I have Scoliosis (incredible that it was missed, gobsmacking actually) and the situation is manageable in the long term, but it's inevitable it will give me more problems as I get older.

 

 

 

Edited May 8, 2021 by Led Lolly Yellow Lolly

[Mister Fixit]

I had my first sciatica attack about 6 months ago.  My father used to get it too, not uncommon for it to run in families.

 

I saw my knee specialist at Phramongkutklao hospital a few weeks afterwards and he suggested that I get some Lyrica (pregabalin) if I should get another attack in the future.

https://en.wikipedia.org/wiki/Pregabalin

 

Thankfully, I haven't had one since, but I did buy some local brand from my local pharmacy should things kick off again.

 

You might want to discuss this with your medical advisor.

 

  

Edited May 9, 2021 by Mister Fixit
Mr Forgetful

[Saltire]

Your story is very similar to my experence of 5 or 6 years ago when living in SIem Reap, Cambodia.

 

I went to see a doctor in a Chiang Mai hospital and ended up with an MRI, the results of which were inconclusive. The doctor didn't seem too interested.

 

6 months later the pain was much worse, and I had to go again, but this time went to a well known private hospital in Bangkok. By this time I could not walk more than 50 metres without sitting down. I chose a hotel close to the hospital but the wallk there was agony.

 

One more MRI and one more disinterested doctor who agreed there was nothing conclusive (after 3 minutes of looking at the result) but highly recommended a $30k+ fusion operation on my lower spine (with no guarantees).

 

Dismayed I returned to Cambodia where a friend suggested acupuncture. I was ready to give anything a try and luckily there was a Beijing-trained Swiss girl opening a practice in Siem Reap. I felt I had nothing to lose if I gave it a go.

 

She was convinced she could help me, and I decided to give it a go. And bingo, what a relief. After 7 x $20 sessions I was pain-free and still am after all this time. If I walk too far I get a dull, but bearable ache in my lower spine, and I am careful to avoid any lifting.

 

Not saying it would be a solution for you as your 'damage' is more extensive than mine but worth considering, and as ever, take Sheryl's advice.