MRI Results and Major Issue in Lumbar Spine - What now?

T12 - L1: Unremarkable.
L1-2: Unremarkable.
L2-3: Broad-based disc protrusion. Moderate central stenosis. Mild bilateral foraminal stenosis.
L3-4: Broad-based disc protrusion. Hypertrophic changes of the facet joints. Moderate to severe central stenosis. Mild bilateral foraminal stenosis.
L4-5: Hypertrophic changes of the facet joints causing grade 1 anterolisthesis and severe central stenosis effacing CSF around the nerve roots. Moderate right foraminal stenosis. Mild to moderate left foraminal stenosis.
L5-S1: Mild disc bulge. Left paracentral disc protrusion which abuts and possibly impinges transiting left S1 nerve root. Moderate right foraminal stenosis. Mild to moderate left foraminal stenosis.

Is there a way to upload a photo here? The MRI image is sobering.

For the last 4 months I’ve had pain deep in my right buttock, and numbness in my right leg ankle and foot. Also in my left ankle and foot. Impaired walking and difficulty sleeping. Taking Gabapentin and had a steroid injection three days ago. First day the pain was much less but since then it has returned.

I was told this is normal and it tales several days or a week for the full effect of the injection to take hold.

I’ll write more in my next post. Thanks for any good words!

Susie, my next appt. with the Dr. Is in July though she told me I could contact her at anytime with questions of concerns. I’ve been on Gabapentin 3 weeks now and am up to 3 300mg pills per day.

I cannot seem to post the image of my MRI film. I tried both the image and url tags and no luck. Any suggestions? Thanks!

My MRI photo. Note the compression of the nerves between L4-5, and also the offset vertebrae. I believe the numbness in my legs and feet as well as the pain are due to this compression. The injection may at some point help the pain but I cannot see it helping with the numbness. Maybe the PT Karen mentioned will help. I have an appt. with a PT therapist on June 13th and I’ll see what she says about the McKenzie Extension.

Thank you, Chartreux. I think I’m on the right track so we’ll see.

Thank you, Susie. The Dr. has increased the Gabapentin dosage from 300mg once a day to 300mg three times a day. This was done gradually over about 6 weeks. I’m looking forward to my PT on June 13th. Right now I’m up for anything that will help. I forgot to mention that I have had some pain relief from medical cannabis. As I’m diabetic I do have to be careful when taking edibles. So far it’s been ok. Thanks for all the good words and info!

Latest update:

I've been to PT twice now and am going again this afternoon. Two different sets of exercises haven't really helped much, if at all. Pain and numbness in my right foot, leg, and now right hip has increased and is much worse at bedtime, making sleeping difficult as I can only get some measure of relief in one particular position.

I emailed my Phys Med Dr. and she sent a referral to neurogery at Kaiser Sunset (where I had my cervical laminectomy and fusion 3 years ago). She also fiiled out a form authoring a temporary handicap parking placard and I mailed that in a few days ago. I'm now waiting for a call from neurosurgery to schedule an appt. for a consult.

It looks like the handwriting is on the wall.

Coincidentally a friend had this exact L4-5 issue a couple of years ago and was very helpful in describing her experiences with symptoms, surgery, and recovery. She advised me not to wait too long because of the worsening symptoms and possible further compression/damage to the nerve root, and also my age - I'll be 73 next month. I certainly don't want to become even more disabled than I already am: not being able to walk very far, even with a cane, and not being able to drive more than a short distance because of a lessening ability to feel the gas and brake pedals due to increasing numbness after 15-20 minutes behind the wheel. UGH.

Nancy, I think getting in with NS is an excellent idea. The numbness & such is not good. Your friend gave you some great information. Nerves are tricky & she is right about letting it go too long. I have seen this before, people either afraid of surgery or just refused to do anything. By the time they got around to the surgery, they had waited too long & the nerve damage was permanent. This happened to a friend of mine, she walks with a really bad limp. The nerves became so damaged. She knew going in the odds were not in her favor, but at least the surgeon was able to fix the mechanical part.

The injections are like putting a band-aide on the problem. If they work, its temporary. Then you get into issues with the steroids having the potential of causing even worse problems. They are not a long term fix at all.

Keep us posted please.

OK, here’s the latest update: I met with Dr. Brara on 8/1 as planned. He spent a lot of time asking questions, checking my reflexes and going over the MRI from every angle -including top down, which was quite interesting. He said at this point due to my deficiencies and increasingly limited mobility that surgery was my best option. It would be a decompression, realignment, and fusion of L4-5 and decompression of L5-S1. Before surgery, however, he ordered a new MRI to review my cervical spine so he can see the precise correction and alignment of C3-T2 from my surgery in 2015. This MRI is on for 8/23. His surgery schedule is 6 weeks out right now so I’ll have an exact date for surgery after he sees the MRI. My next step is to re-read “Prepare for Surgery - Heal Faster” by Peggy Huddleston, the book that helped me tremendously deal with undergoing surgery and subsequent healing from the 2015 laminectomy and fusion. I’ll post again when I have the surgery date.

Thank you for the good words and encouragement, Karen. I do appreciate it. I really feel connected to and supported by my Healing Well family!

Thank you so much, Susie! Dr. Brara said that although this is a major surgery, its much less complex than the 2015 operation. I hope to do at least as well recovering as I did back then - if not better.

Nancy, it sounds like you have your plans in place for next Tuesday. Try to relax as much as you can over the weekend, in other words do something nice for yourself!!

We will be sending many healing thoughts & prayers your way. Looking forward to hearing surgery went well.

Take care.

You are in my prayers.

Nancy:
It is good to hear from you with surgery for your lumbar spine in the rear view mirror.

It sounds as though you are in good hands with Dr. Bara, whom you know and trust from prior cervical surgery. Having a skilled surgeon makes a difference in recovery, healing, and outcome.

Thanks for making the effort to check in. Best wishes to you for gentle healing,
Karen