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Hello, welcome to Justanswer, I will try to assist you with your medical question, and any medical information you seek
With the symptoms you have described, I think surgery is your best option
I work in orthopaedics, and the symptoms you have will likely get worse over time
it will likely eventually lead to muscle weakness and wasting
up to what level of the spine noting the MRI would you suggest?
Based on your symptoms, L4-L5 for sure, not L5-S1, it does not say anything bout L3-$, so I assume it is normal
L2-L3 ,L3-4 AND L5-S1 WERE LISTED WITH MY INITIAL RESPONSE PER MY REPORT
I see, then I must be missing the initial part of the report, because it did not show up, is the part you typed under the "impression"
EACH SPINAL SECTION REPORTED SEPARATELY IN THE INITIAL REPORT SUBMITTED
That means the whole thing did not show up in your post
Do you see the part that says "impression"?
I CAN RESEND THOSE SECTIONS NOW L2-L3 MILD ANNULAR BULGE.FACET DEG CHANGES.L3-4 ANNULAR BULGE AND BULKY FACET DEG.CHANGES.WITH MILD CENTRAL SPINAL STENOSIS AND SUBARTICULAR ZONE COMPRESSION.L4-L5 ANNULAR BULGE WITH SUPERIMPOSED RIGHT FORAMINAL AND EXTRAFORAMINAL BROAD-BASED DISC PROTRUSION IN COMBINATION WITH BULKY FACET DEG. CHANGESSEVERE CENTRAL SPINALSTENOSIS AND SEVERE BILATERAL SUBARTICULAR ZONE COMPRESSION WITH MILD RIGHT FORAMINAL STENOSIS THE L5-S1 IS SHOWN IN MY POST FROM THERE
Thank you for that
The findings from L2-L3 are not serious and do not require surgery, it would not benefit you to have any surgery from L2-3
Findings in L5-S1 are also not changes that would require surgery
Any surgery done in those areas would make your quality of life worse if done now
The problem lies in the L4-5 region
Are you there?
YES WHAT ABOUT L3-4?
L3-4 shows some mild changes, and they are not severe enough for surgery at all, not even close, 50% of the population have those changes on an MRI
Also, if an MRI was done on 100 people, about 50% will show many of the changes you have , apart from the L4-5 changes
Are you still there?
WOULD I NEED CORRECTION AT SOME LATER TIME WHEN YOU RESPONDED ABOVE THAT MY QUALITY OF LIFE WOULD BE WORSE IF DONE NOW. ALSO WILL CONTINUE TO HAVE BACK PAIN DESPITE THE SURGERY INDICATED? I AM A SURGICAL NURSE AND KNOW PERSONAL FRIENDS WHO HAVE HAD TO HAVE REPEAT SURGERY AND/OR EPIDURALS AND PAIN MEDS. HAVE YOU SEEN BETTER RESULTS WITH THE NEWER PROCEDURES OUT NOW? I WAS VERY ACTIVE BEFORE THIS INJURY ACTUALLY WORKED 2 NURSING JOBS,WENT TO THE GYM 4-5 DAYS A WEEK AND HAD AN ACTIVE SOCIAL LIFE.I PARTICIPATED IN WALKS FOR CANCER AND KIDNEY DISEASE AND WAS a TRAVEL NURSE ALSO.MY LIFE HAS DONE A 360 DEGREE TURN AND HAVE HELP THAT COMES IN. I WANT TO STAY OPTOMISTIC BUT WANT TO KNOW WHAT I AM FACING AHEAD ALSO
YOU ASKED ABOUT THE IMPRESSION ON THE BOTTOM OF THIS REPORT AND IT READS MULTILEVEL LUMBAR DEGENERATIVE SPONDYLOSIS
From your MRI and symptoms, it is unlikely you will need surgery laterYour back pain will likely resolve with surgery, the newer procedures have not shown better resultsThere is an excellent chance that surgery will improve all of your symptoms
COMPROMISES CENTRAL NERVE ELEMENTS MOST PROMINENTLY EFFECTING L4-5 AND L5-S1 AS DESCRIBED ABOVE
Okay, thanks for the impression
From everything you have told me, I think the scheduled surgery is the best option
I mean the posterior decompression and fusion
BMP just aids bone fusion/healing
YES I AM HERE
Did you understand my replies?
YES AND I APPRECIATE YOUR FEEDBACK
WHAT KIND OF RECOVERY TIME HAVE YOU SEEN IN PRACTICE?
Recovery time is 8-12 weeks
THEN REHAB TIME?
Rehab time can be anywhere from 4-12 weeks on average
SO I SHOULD PLAN FOR APPROX 24 WEEKS? I WILL NEED TO NEGOTIATE STAIRS IN MY HOME ALSO
You should plan for 8-12 weeks, during the rehab time you will not be incapacitated
BUT WILL BE GOING TO THERAPY DURING THE REHAB TIME,IS THAT CORRECT?
Yes, that is correct
It may be very short ,sometimes 2 weeks
THANK YOU AND I WILL SIGN OFF NOW,GOOD NIGHT!
You're welcome,If you have other questions at another time you may request me by starting your question with "for Dr Brims"Please let me know if you have any other questions or concerns on this topicIf not, please click the green ACCEPT button to end this chat session