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Multilevel Degenerative Changes Within Lumbar Spine, Disc Bulging, Hypertrophy

Posted on Fri, 7 Sep 2012

Question: the vertebral bodies are normal in height and alignment. There is normal marrow signal. Patient is status post posterior spinal fusion at the L4/ and L5 levels. there are disc spacers at L4/L5 and L5/S1. L3/L4: Disc Bulging and facet hypertrophy result in mild central canal stenosis and mild bilateral neural foramainal narrowing. L4/L5: Disc Bulging and facet hypertrophy along with a left paracentral disc protrusion results in moderate central canal stenosis and moderate to severe left neural foraminal narrowing. There is moderate right neural foraminal narrowing. There is no abnormal signal within the conus. There are no abnormal enhacing lesions. Imprsession: Multilevel degenerative changes within the lumbar spine

Answered by Dr. Krishna Kumar (13 hours later)

Hi XXXXXXX

I have seen the report stating post spine fusion with some canal stenosis.

Please get back to me with your query as I would like to know more about your symptoms and suggest you accordingly.

Awaiting your response.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Krishna Kumar (8 hours later)

I have nerve pain in both of my hips and thighs, it not constant but it is very intense a lot of the time. I have been hurting with this pain sense a year ago. But it is getting worse, I have had 4 back and 1 cervical surguerys in the past. The last spinal fusion i have had was back in 2003. I work every day as a school bus mechanic and have for the last 28 years. I have a lot of chronic back pain, and take 120mg of oxycotin and 20mg of percocet a day. I do not want to take anymore pain medication than i taking now. I am also experencing pain in the center of my back which the mri did not show.

XXXXXX

Answered by Dr. Krishna Kumar (8 hours later)

Dear XXXXXXX

Thanks for posting a detailed history. My opinion after reading your details is:

You have already undergone 4 low back surgries and you are still in constant pain. So I would group you under “failed back surgery" group. Another surgery for you may or may not help. So you must try all other modalities before you embark on another surgery.

I assume all your screws in the back are in position without any breakage (X-ray would help us know about its status).

I also suggest that you check your bone density by a test called Dual Emission X-ray Absorptiometer (DEXA) scan and also check your vitamin D, parathormone (PTH) and Uric acid levels. You may have underlying osteoporosis / osteomalacia in addition to lumbar degeneration.

I also suggest you try lumbar spine exercise with the help of a physiatrist and also try swimming if possible.

The back pain in the centre of your back is part of lumbar degeneration.

Hope this address your concern. Let me know if you have any more concerns.
And if all your queries are answered, please close this discussion.

Wish you good health

Regards

Above answer was peer-reviewed by : Dr. Prasad