Hi there, I posted on this back in May i think it was…I finally got hold of the scans on a disc…some of you kindly offered to give me your opinions…here are some of the images…
some more:
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and 2 more…if anyone wants to look at other angles I have them…the reason id like someone to give me their opinion is because i havent been sat down to be told whats what yet by the specialist…the appointment is next week…
Find someone who is certified in the Robin MacKenzie method. I didn’t believe it would work. It’s so simple. I was back to about 90% in 6 months. Easy.
FWIW, My Dx:
Lumbar degenerative disk disease at L5-S1 with Modic (type II) changes.
Options: Chiro or PT, meds
No surgery right now unless you fail chiro/pt. Focus on lumbar stabilization exercises/core
Without radicular complaints, you arent really a candidate for epidural injections. However, facet injections are a possibility if conservative therapy fails.
LAST resort would be lumbar fusion of L5-S1. From your symptoms, I dont think you’re anywhere near this step though.
I agree with most of the above, but epidural injection here can be pain relieving. Less pain lets you do more in PT.
The epidural just about saved my life!!! And, doc may suggest another, will see on Tuesday. I hear you can have up to 3, 2 weeks apart.
Dave
LAST resort would be lumbar fusion of L5-S1. From your symptoms, I dont think you’re anywhere near this step though.
There was a discussion on here maybe 6 months ago about replacement disks too. Plenty of people
more educated than me on the subject provided input. I suspect search would find it.
If I had a choice and the results were good, in theory I think disks are better than fusion.
The key there is “in theory”. 
-Jot
probably true, but getting better without surgery is the best option.
What a crap scan… can’t even see the whole aorta… Sorry, just the vascular surgeon in me.
Agreed with the other reads and starting conservative. As for artificial disc vs fusion, our orthopods do a fair number of artificial disc cases and are pleased with the results…
Stephen - pretty hard to interpret this scan on my lap top and the radiologist/orthopedist who’s read it for you has a significant advantage over us. That said, you appear to have some degenerative disease at L5 -S1…but then so do 1/3 of the people reading ST! There have been a number of studies done over the years on asymptomatic individuals and plenty of them look just like you. Dr. Pete and I might also! Well, I’m probably older so we’ll say it’s me.
Also, you’d be wise to keep surgeons out of your back as long as humanly possible and, before I’d let somebody think about an artificial disc in me, I’d research publications like the Jounal of Bone and Joint Surgery and see if they think there’s a difference 4, 5, 10 years out between said disc and a fusion. It sounds like you have a ways to go in the diagnosis/conservative treatment part of the game. Do you know any Physiatrists? They’re terrific at this sort of problem and very patient. Good luck.
You’ve gotten some decent advice (from johnpost md) and alot of really shitty advice. Like he said, the radiologist probably has a MUCH better picture, but from what I’m seeing, I see degenerative disc disease at L5-S1 as well as a retrolisthesis of L5 on S1 (it’s “slipped” backwards). In terms of your pain, this means jack shit. You very well could have no pain, and then you could very well have no sensation to your legs, can’t pee, etc. If you EVER have numbness in your groin, have bowel/bladder/sexual function issues, get to an ER and SOON (if that happens, you should be in surgery within 72 hours for optimum resolution). Beyond that, down the road you may want to consider disc replacement or lumbar fusion. Hold off as long as possible, because once you go down that road you start to get other problems secondary to that due to movement compensations. In terms of treatment, DO NOT get a manipulation (“somebody cracking your back”). That wont fix anything, and it has the potential to make it worse. Stretching and core strengthening is the way to go. Stretch hamstrings, hip flexors, hip rotators, etc. Do all of this with a neutral spine. No bending forwards, or too far backwards. The advice for McKenzie stuff is unfortunately wrong. It works great for disc bulges, but not something of this character. For stretching, lay on your back, loop a belt around your foot and bring your leg up, across, out to the side, whatever, to stretch your hip. To hit your flexors, lay on your back with your hip off the side of a bed and let that leg fall to the floor. For strengthening, planks work great (front, side, back).
That’s it for now. If you want anything more, drop me a note.
Phil Gregory, DPT, CSCS
I thought all other surgeons viewed orthopods and as people who act like
lumberjacks on the human body. 
“Bring out the chainsaw, the cum-a-long and a BIG hammer”
-Jot
I thought all other surgeons viewed orthopods and as people who act like
lumberjacks on the human body.
“Bring out the chainsaw, the cum-a-long and a BIG hammer”
-Jot
Yeah, so what’s your point?
Yeah, so what’s your point?
I want a miniature bear to show up in the images on my future MRIs.
-Jot
I don’t do miniature bears, but I can drop one of these in your aorta and it makes a nice picture on X-ray and CT…
I don’t do miniature bears, but I can drop one of these in your aorta and it makes a nice picture on X-ray and CT…
That’s just not right. Next time I read a CT f/u on one of those, I’m going to have this goofy image of what looks like a pair of pajama pants in my mind.
and, agree with whoever said there is a little retrolisthesis of L5 on S1. May or may not be clinically significant.
Like johnpostmd said, probably a lot of us have similar findings and don’t know it. I do know my neck looks like an old person’s, and hardly ever sxatic.
I am fully qualified to help you out, but there are a few small issues to contend with:
It would be a HIPAA violation to share information about your scan with others. I would need a signed and notarized release.
It would be Medicare fraud for me to give you an interpretation for free when I charge the US government a fee (which they set of course)
I feel certain it would be some violation in interstate commerce law, if not international.
Oh how fun to be a physician in the US. Can hardly wait for Obama to fix it all.
PS if you would post all the images in the T2 sagittal sequence, it would be helpful - all 12 images from the sequence labeled ESAG/TSE/T2. These are high quality images you submitted and can be seen well if you click on them to mag.
Trust me when I say that I suspect one of my aorta already have some nice
imaginative structures to display on an MRI for you. (It wouldn’t show
up on an xray, but a CT might show it)
Then again, maybe it looks normal. That would be very disappointing.
-Jot
as ever i am overwhelmed with the response from people…i will read it all out carefully…