
Not Able To Walk Properly. Have Herniations In Cervical, Bowel Movement Problem. May I Need Surgery?

L4-5 level: Posterior disc space narrowing is seen. Central disc herniation with annular tear impinges upon the thecal sac and nerve roots. There is facet joint hypertrophy with inflammation and moderate canal narrowing.
L5-S1 level: Posterior disc space narrowing is present. Left paracentral disc herniation with annular tear impinges upon the anterior thecal sac and left nerve roots.
Now I was wondering how serious this may be? I have trouble walking, currently am not able to move my right or left foot from the ankle down/also no toe movement on either foot (I have been diagnosed with drop foot as well), I also have a right paralized hand....and over the past few months my fingers on my left hand has been acting up as well. I have horrible pain from my neck down to my lower back. I also have issues with bladder and bowel movements. I have herniations in my cervical and thoracis spine areas as well. All this from a fall injury 2 years ago, and my symptoms continue to get worse. I am in between treatment right now because I was hurt on the job and I am dealing with workers compensation and my employer not wanting to take responsibility for my injury....so it has been a struggle.... I am waiting to see a back specialist, but in the meantime I was wondering if you would be able to give me a little bit of an insight as to how serious this mri report may be...and if I may need surgery?
There is a vertebral disc between each vertebra, it acts as a shock absorber, it is composed of two parts, the outer part called the annulos fibosis (your report mentioned a tear in the annular ring) and the inner aspect , that is normally fully surronded by the annulus, called the nucleus pulposus.
Because the lower back has more motion than the thorax and carries all the weight of the torso, it is more commonly injured.
The lower disc L4-L5 and L5 to S1 take the most strain and are more likely to herniate.
Your report states that there is narrowing of the space between L4 and L5 which is usually due to degeneration of the disc.It also states that in the left aspect of the spine (as it relates to L4 and L5) there is a tear in the annulus that I mentioned earlier with herniation of the central disc (nucleus).This is compressing on your nerves and would be contributing to your symptoms.
In terms of the facet hypertrophy mentioned-Facets are where the vertebra interact with each other and move.Hypertrophy means that these 'joint area' become enlarged.The damage that you got in your discs could have possibly resulted in problems with the facets.Potential facet hypertrophy can result in narrowing of the spinal canal.
Treatment of facet joint hypertrophy can be conservative (pain medication, steroid injections, physio) or surgical.Degenerative disease is one of the most common indications for surgery.
In terms of L5 to S1- again there is narrowing of the space and herniation noted towards the left.
The indications for surgery with persons with lumbar disc disease are:(1) persons with a condition called cauda equina syndrome which is a pattern of neurological , muscular and urogenital symptoms due to compression of certain nerves in the lumbar sacral area.The symptoms would be lower back pain,sciatica, bladder and bowel symptoms,loss of sensation in the buttocks and perineum,muscle weakness.It is a serious condition, you mentioned that you have bladder and bowel dysfunction, your doctor should evaluate you for this.Treatment is aimed at the cause of the condition.
(2)if the neurological deficit is observed to be worsening-if your symptoms and difficulites are progressing
(3)sciatic pain for a 6 to 12 weeks
Sciatica-this is leg pain that is related to one or more of the nerves coming out from the lumbarsacral spine
In general I believe that you may be a candidate for surgery as you state that your symptoms are significant and progressing however your that is an area that your neurosurgeon and yourself will discuss.
I hope this helps and I wish you the best,feel free to ask any other questions


I am really sorry about the physical trauma you would have suffered at work and the subsequent emotional trauma and frustration that you must be experiencing trying to obtain appropriate treatment.
I hope all of the red tape is resolved and everything is put in place for you to see the doctors and receive the treatment that is owed to you
wishing you the best

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