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What Does "Low Back Pain With Bilateral Lower Extremity Radicular Symptoms" Mean?

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Posted on Sat, 22 Feb 2014
Question: Need help understanding (what it means) an MRI I had done: History: Low back pain with bilateral lower extremity radicular symptoms, right greater than left. Normal curvature and alignment. No compression fracture. Normal conus medullaris L1-2: Mild facet hypertrophy. No focal disk abnormality or stenosis L2-3: Mild facet hypertrophy. No significant disk abnormality or stenosis L3-4: Mild facet hypertrophy with no significant disk abnormality or stenosis L4-5: Mild facet hypertrophy with minimal disk protrusion and no more than mild inferior foraminal narrowing. No focal disk herniation or high grade stenosis L5-S1: Moderate to sever facet disease, which is mildly asymmetric. This associated with a tiny central disk protrusion, which shows evidence of a tiny annular rent. The facet disease contributes to at least moderate foraminal stenosis, which appears to be slightly greater on the left. Summary: 1) Mild degenerative disk and facet changes throughout lumbar spine. 2) Facet hypertrophy and spurring produces moderate bilateral foraminal stenosis at L5-S1. Coorelate for L5 radicular symptoms
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Answered by Dr. Vaddadi Suresh (36 minutes later)
Brief Answer: facet joint lies between two vertebrae. Detailed Answer: Hi XXXX, you have 12 small bones called thoracic vertebrae (T1 to T12) and 5 small bones called lumbar vertebrae(L1 to L5) in your back. There are discs called inter vertebral discs in between which are shock absorbers. The spinal cord which gives nerves, lies within a central canal formed by these vertebrae. The nerves start from lateral sides of the spinal cord and come out through the gaps on sides between each vertebrae. The nerves are named similarly. for eg; L4 nerve comes from a gap between L4 and L5 vertebra. facet joint is the joint that lies between two vertebrae. If the exit area for the nerve is narrowed (foramenal stenosis), you will have nerve compression of that particular nerve and you will feel pain in that particular area supplied by the nerve. In your case, as there is compression of L5 nerve, you must be feeling pain o shock sensations along your lateral aspects of both legs. For a non medical person, it is difficult to understand; but i hope i have made reasonable answer. All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vaddadi Suresh (10 minutes later)
This MRI was done on November 6, 2013. I had another one done on XXXXXXX 24, 2014. Can you see it? If so, can you tell me if there has been any changeere it is: I got my MRI results and need help understanding it: There is exaggerated lordosis At L5-S1 there is disc degeneration with desiccation of disc material and loss of normal T2 signal and disc space thinning. Bilateral spondylolysis is suspected, with facet arthropanthy observed. There is mild anterolisthesis of L5 on S1, grade 1 spondylolisthesis. There is diffuse disc bulging more prominent in the left pericentral. Within the bulging disc material is curvilinear T2 signal hyperintensity, suspect an annular tear. There is moderate bilateral foraminal stenosis, greater on the left. There is relative mild narrowing of the spinal canal with disc material abutting the thecal sac and the S1 nerve root origins, without significant mass effect on these structures. The remaining disc spaces are maintained, with normal hydration, without focal protrusions or herniations. There is facet arthropathy identified at L4-L5 and to a lesser degree L3-L4. There is moderate bilateral foraminal narrowing appreciated at L4-L5. Normal marrow signal is noted in the bony structures of the lumbar spine. Particulary, there is no evidence of fracture or bone marrow edema. There is no marrow replacement process. There are no signal abnormalities identified in the distal cord or conus medullaris region. Impression: 1) Disc degeneration at L5-S1, with bilateral spondylolysis suspected with grade 1 spondylolisthesis of L5 on S1. Diffuse facet arthropathy. Diffuse disc bulging with relative mild narrowing of the bony spinal canal, without spinal significant canal stenosis. Annular tear suspected in the bulging disc, left paracentral. 2) Facet arthropathy at L4-L5 with relative mild to moderate bilateral foraminal narrowing. 3) Exaggerated lordosis
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Answered by Dr. Vaddadi Suresh (7 minutes later)
Brief Answer: If you post it as a file, i can see and comment Detailed Answer: Hi, If you post it as a file, i will see and comment. Or you can keep the report. from your earlier report, i dont think there will be anything that would change as 3 months is too short a time for progression of spine diseases. hope this helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vaddadi Suresh

Internal Medicine Specialist

Practicing since :2003

Answered : 963 Questions

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What Does "Low Back Pain With Bilateral Lower Extremity Radicular Symptoms" Mean?

Brief Answer: facet joint lies between two vertebrae. Detailed Answer: Hi XXXX, you have 12 small bones called thoracic vertebrae (T1 to T12) and 5 small bones called lumbar vertebrae(L1 to L5) in your back. There are discs called inter vertebral discs in between which are shock absorbers. The spinal cord which gives nerves, lies within a central canal formed by these vertebrae. The nerves start from lateral sides of the spinal cord and come out through the gaps on sides between each vertebrae. The nerves are named similarly. for eg; L4 nerve comes from a gap between L4 and L5 vertebra. facet joint is the joint that lies between two vertebrae. If the exit area for the nerve is narrowed (foramenal stenosis), you will have nerve compression of that particular nerve and you will feel pain in that particular area supplied by the nerve. In your case, as there is compression of L5 nerve, you must be feeling pain o shock sensations along your lateral aspects of both legs. For a non medical person, it is difficult to understand; but i hope i have made reasonable answer. All the best.