[runner]

No answers

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Well, folks, I got back my MRI and back x-rays and they don't show much about why I have sciatica/numbness/radiuclopathy in my legs and feet.

Talk about frustrating. It is good I don't have full-blown herniated disc problems but my doctor does not know why I have the sciatica/ et al. He said I could have problems from the disc moving more and could have irritated something.

Here is my MRI Result (For those of you astute about interpreting MRIs):

MRI Lumbar W/Without Contrast

IMPRESSION:
1. SURGICAL CHANGES WITH AN ARTIFICIAL DISC AT L4/L5. LIMITED EVALUATION
OF THE L4 and L5 VERTEBRAE AND LUMBAR SPINAL CANAL DUE TO METALLIC
ARTIFACT. EVALUATION OF THE NEURAL FORAMINA ARE THIS LEVEL IS ALSO
LIMITED. GIVEN THIS LIMITATION, NO CENTRAL CANAL STENOSIS THROUGHOUT THE LUMBAR SPINE IS DEMONSTRATED.
2. THERE IS ONLY MINIMAL TO MILD NEURAL FORAMEN NARROWING. NO SIGNIFICANT NEURAL FORAMEN NARROWING IS DEMONSTRATED.
3. MULTILEVEL HYPERTROPHIC CHANGES OF THE FACETS/LIGAMENTUM FLAVUM AS DESCRIBED BELOW.

TECHNIQUE:
Multiplanar, multisequence MRI was performed with and without contrast.

FINDINGS:
Comparison: Prior radiograph of the lumbar spine 09/15/2008.

An artificial disc prosthesis is again noted at L4/L5. There is normal alignment of the lumbar vertebrae. There is normal termination of the cord with the conus at the level of L1.

There is no evidence of bone marrow edema.

At L1/L2, there is only minimal bulging of the posterior disc without central canal stenosis or neural foramen narrowing.

At L2/L3, there is only minimal bulging of the posterior aspect of the annulus without central canal stenosis or neural foramen narrowing.

At L3/L4, there are mild hypertrophic changes of the ligamentum flavum. There is minimal bulging of the posterior aspect of the disc without evidence of central canal stenosis. There is minimal neural foramen narrowing bilaterally.

At L4/L5, there are hypertrophic changes of the facets and ligamentum flavum. Evaluation of the thecal sac and cauda equina is limited due to metallic artifact. No definite spinal canal stenosis is appreciated. No significant neural foramen narrowing is demonstrated although there is metallic artifact overlying the neural foramina bilaterally as well.

At L5/S1, there are hypertrophic changes of the facets. There is only minimal bulging of the posterior aspect of the disc without evidence of central canal stenosis. There is minimal neural foramen narrowing bilaterally. Multiple suspected follicles are partially visualized in the region of the right adnexa on image 9 of series 4. Postcontrast images demonstrate no areas of abnormal enhancement to suggest epidural fibrosis. However, again evaluation of the L4/L5 region is limited due to metallic artifact.

The x-ray wasn't too much help, either.

HISTORY: Status post fusion and lumbar disectomy.

IMPRESSION:
1. STABLE APPEARANCE OF THE LOWER LUMBAR SPINE WITH AN ARTIFICIAL DISC AT L4/L5 AND MILD DEGENERATIVE CHANGES OF THE LUMBAR SPINE WITH HYPERTROPHIC CHANGES OF THE FACETS.
2. NO EVIDENCE OF MALALIGNMENT ON NEUTRAL, FLEXION, OR EXTENSION VIEWS.

FINDINGS (LUMBAR SPINE, FIVE VIEWS):
Comparison: Prior radiograph lumbar spine dated 09/15/2008.

An artificial disc is again noted at L4/L5. There are surgical clips adjacent to the lower lumbar spine and upper sacrum. There are mild degenerative changes of the lumbar spine with small anterior spurs. On flexion and extension and neutral views, no significant malalignment is demonstrated. There are hypertrophic changes of the facets of the lower lumbar spine.

That's it.
I stay on the Gabapentin and go back in six weeks.


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