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Disc bulge
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Apmullins79 posted:
I would like to put MRI results here and get an opinion. Hurt my back at work on 4-1-11. Have lower back pain, pain radiates down left leg. Test shows disc bulge at L5-S1. My neurosurgeon doesn't act concerned with the report, although he did have me do a myelogram Xray/CT, and bone scan today. I go back on 5-9-11 for results. I am in constant pain on my left side, any advice would be appreciated. By the way this is a workers comp claim if that helps. Conus medullaris terminates at the aprox level of L1. Small area of T2 signal seen within the left kidney. No evidence of significant edema pattern seen within the lumbar vertebral bodies. L3-L4 mild disc bulge seen with mild right greater than left neural foraminal narrowing. L4-L5 Disc bulge seen with mild narrowing seen at the level the facets. L5-S1 Disc bulge seen eccentric to the left. Left greater than the right narrowing seen particularly at the level the facets. Apparent effacement versus contact of the exiting nerve root noted to the left please correlate clinically include with physical exam results. If intervention is warranted followup including documentation of leveling advised.

Impression: Lumbar discogenic disease most pronounced at the L5-S1 level where apparent effacement of exiting nerve root noted on the left.
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bj1208 responded:
hi and welcome to the support group -

as you have mentioned this is a work comp claim, have you hired an attorney to help protect your rights? If not do so ASAP - the reason for this is work comp has been established to help protect the company - it does not protect the employee. Granted they have a set of doctors to help when there is a claim but does not give the employee all the rights.

first thing - hire an attorney that handles ONLY work comp claims - they will make sure you are seeing the right kind of doctors and are getting the right kind of treatments.

I am going to give you a couple of sites that help lay people (us) with terminology -

http://www.chirogeek.com/

http://www.adriaanliebenberg.co.za/tests/terminology-for-ct-scans-and-mri-scans-lumbar-region.html

the first site - chirogeek is by far one of the best that I have seen - both sites give you the ability to search thru them -

from what I can see is that you have 3 bulging discs - at L3-4; L4-5 and L5 - your L5 disc is bulging to the left and is pressing on the S1 nerve root which is causing the pains down your left leg.

the Neurosurgeon you are seeing - is he/she a spine specialist?? there is a big difference so please be sure that they are a spine specialist -

Also, is this the doctor that the work comp has set you up with? If possible, get another opinion from either an Orthopedic Spine Specialist or Neurosurgeon Spine Specialist - you may have to go thru the work comp company - this is where having a work comp attorney comes in handy - they can make sure you are seeing the right physicians. Also, because of your injuries, you should be entitled to compensation and the attorney will help with that - there are ones out there that will take their fee when they get you money - no money no fee -

please be sure you contact an attorney and see what your rights are - with work comp claims there is a lot at stake and that is you - please keep us posted - take care - Joy
 
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Apmullins79 replied to bj1208's response:
Thank you Joy for your reply. I have my rights asserted through the state of VA, I should have mentioned that sorry. Insurance co has started paying ttd benefits and have approved all my tests thus far. My worry is doctor is down playing my injuries although he did order the additional tests.( Myelagram, CT, Bone scan) I won't get results til this coming Monday. I have put a call into a lawyer but haven't set up a free consultation, I was actually waiting for results and docs opinion on further treatment before going to a lawyer. It's hard to find one that just does WC cases, the lawyer I found only does personal injury cases though. WC, Disabitility, etc..... That's all the firm handles, probably give them a call Monday. I appreciate your advice, I to feel like I have a pinched or compressed nerve. Although doc is acting unconcerned but like I said it is workers comp and they are only out to conserve their losses. Anyone else out there especially DOCS please shed someight on my MRI.
 
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bj1208 replied to Apmullins79's response:
QUESTION FOR DOCTORS - please see posts and let member know -

Sometimes the board is slow on weekends - if no response put a new post up and label it; QUESTION FOR DOCTORS -

take care - Joy
 
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Nomaan Ashraf, MD, MBA responded:
Hello
I'm sorry to hear that you are having so much pain. It's hard to make a diagnosis just based on the radiologist report without looking at the actual films. Many of the findings such as "disc bulge" or "mild foraminal narrowing" are very common and some studies have shown present on 50% of the population that has no symptoms. So, please do not let all of the vernacular on the radiologist report alarm you as the important thing is how the MRI findings match up with your symptoms.
That being said there is a good chance that the L5-S1 level is the culprit here. You may havedisc degernation, a small disc herniation or some stenosis at this level giving you the back and leg pain.
That being said, the majority of times this can be managed conservatively and surgery is only performed as a last resort and is usually not necessary.
I hope this was helpful
 
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Apmullins79 replied to Nomaan Ashraf, MD, MBA's response:
Thank you for reply, I have been in PT and have had my first epidural steroid injection. Also have had several work hardening sessions. I was feeling pretty good two days after shot and over did it yesterday. Now feel like I'm back to square one. My job is physically demanding and am thinking of changing careers I'm afraid if I go back I will re-injure my self. This injury happened April 1, 2011, not getting any better. Any suggestions?


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