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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I had a MRI and I have L3/L4 grade 1 anterolisthesis of L3

Customer Question

I had a MRI and I have L3/L4 grade 1 anterolisthesis of L3 ovr L4 with slight disc uncovering moderate facet and ligamentum hypertrophy with triangulation of the thecal sac. No significant neurologic impingement
L4/L5 disc desciccation disc height loss moderate broad-based disc bulge ligamentum/facet hypertrophy causes moderate right and moderte to severe left effacement of the exicitng nerve root these are the areas that i have problems i am in a lot of pain and cannot stand for any period of time without pain it is affecting my bowls
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your statement and reply shortly. Please read this preliminary answer and respond. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

How old are you Lynn? Any other medical problems. Are you taking pain meds for this problem, hence the constipation/pain? There are new treatements for this if it is opiate based. Are you a surgical candidate (no major health issues, wants surgery-can take the time off, etc)? Do you have a family history of this problem? Do you have weakness into your legs, pain shooting into your legs, numbness in your legs/feet? Does it hurt to sit for prolonged periods? How far can you walk without having to stop for pain? I am here to give you some direction if I can. You have other options than surgery based on this MRI, like physical therapy. As a Neurologist, I would examine you for radiculopathy/spinal stenosis and maybe do an EMG test of your legs to quantify the injuries to your back. Then a decision on management. There is steroid epidural treatments, etc. Please get back to me to discuss this further, ask questions and I will respond to them directly. If satisfied, please remember to rate my service by clicking on the rating stars as that is how I am compensated for this work. Thanks *****

Expert:  Dr. Frank replied 1 year ago.

I would also say that by definition the grade I anterolithesis you note in the report is not sufficient criteria for surgery, but if it evolves to grade II then you might. The triangulation of your dural sac is also concerning, so when put together depending on your clinical symptoms , the neurological examination, and the emg results you make a decision on surgery and PT vs. PT alone. Dr Frank

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