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Confusion about MRI results for L5-s1

Posted by justbec2004 @justbec2004, Aug 27, 2025

Please help with mri results. Also can this cause extreme pain in foot.

S1 segment is partially lumbarized with 5 additional nonrib-bearing lumbar type vertebral segments. Last rib-bearing segment labeled as T12. Conus medullaris terminates at L1 with no abnormal intramedullary signal alteration. Moderate endplate degenerative marrow space findings at L5-S1. No discitis osteomyelitis lumbar spine. Common bile duct measures approximately 0.7 cm. This desiccation at L3-L4 through L5-S1.
At T12-L1, no disc bulge, spinal canal stenosis, or neural foraminal stenosis.
At L1-L2, no disc bulge, spinal canal stenosis, or neural foraminal stenosis.
At L2-L3, no disc bulge, spinal canal stenosis, or neural foraminal stenosis.
At L3-L4, no neural foraminal stenosis or spinal canal stenosis. Posterior disc bulge (2 mm AP).
At L4-L5, mild disc height loss. No neural foraminal stenosis. No spinal canal stenosis. Posterior disc bulge (3 mm AP). Mild bilateral facet arthropathy.
At L5-S1, moderate disc height loss. Mild left neural foraminal stenosis. Moderate right neural foraminal stenosis. No significant spinal canal stenosis. Mild/moderate bilateral facet arthropathy. Broad-based posterior disc osteophyte complex (4 mm AP) with finding extending into the bilateral neural foramen.

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cori | @ccchang | 1 day ago
In reply to @lessie "@ccchang I saw the neurosurgeon yesterday. He was concerned about L3-4, which is the level above..." + (show)
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@ccchang
I saw the neurosurgeon yesterday. He was concerned about L3-4, which is the level above the fusion that I had 2 years ago. He said the MRI looked unusual and that he has seen only 6-7 cases where the nerves are unevenly blocked. He is recommending a laminectomy and the tough part (for him) is convincing my insurance that I need it. Why? Because the radiologist said the following:
L3-L4: Disc bulge and ligamentum flavum thickening causing lateral
recess and mild spinal canal stenosis. Moderate facet arthropathy with
mild left neural foraminal narrowing.
The report says that the spinal canal stenosis is mild when in fact it is moderate to severe and warrants surgery. My surgeon is pretty certain that they will be able to deal with my insurance (Medicare).
As far as the symptoms go, this will help with the sharp, shooting pain in my buttocks that then travels down my legs and into my feet. It should help with the pins and needles sensation as well. It may or may not help with the charley horse cramps in my feet and calves.
We will be traveling in September so we are scheduling surgery in mid October. In the meantime, he has referred me to the pain clinic for an injection, perhaps 2 if there's time before I leave. That should help at least a little bit.

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@lessie If you're traveling in Sept, it sounds like you're able to walk, which is good. Given the numbness in your right foot, are you able to drive? If a laminectomy will resolve your issue, that's great. I've heard that's a fairly routine procedure. I was supposed to get a laminectomy but my surgeon decided to do XLIF instead (fusion/cage/screws). Unfortunately, I still have the numbness and pain. Who's your surgeon and hospital?

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lessie | @lessie | 1 day ago
In reply to @ccchang "@lessie If you're traveling in Sept, it sounds like you're able to walk, which is good...." + (show)
Profile picture for cori @ccchang

@lessie If you're traveling in Sept, it sounds like you're able to walk, which is good. Given the numbness in your right foot, are you able to drive? If a laminectomy will resolve your issue, that's great. I've heard that's a fairly routine procedure. I was supposed to get a laminectomy but my surgeon decided to do XLIF instead (fusion/cage/screws). Unfortunately, I still have the numbness and pain. Who's your surgeon and hospital?

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@ccchang
We will be traveling to Tahiti and French Polynesia. We've wanted to go on our honeymoon, but it's now 50 years later, so we decided to splurge and go. The planning has been a challenge because we want to make sure I"m ok to travel. We are really looking forward to doing a lot of swimming and snorkeling which should be easy right at the beach.
I am able to walk, but do so with a cane outside, and sometimes inside, mostly due to balance issues. The numbness and pain in my foot is on top, so I'm able to walk and drive. Walking is ok, but I limit it to 20-30 minutes because of pain, sometimes while I'm walking but more often after I stop. Standing more than 5 minutes is the worst and what brings on the zinging butt pain and horrible foot/toe pain.
Driving can be a challenge particularly on city streets because my leg frequently starts to ache and the pain in my big toe gets activated. So, I limit driving around to about 20 minutes. I've had 2 surgeries, both at Tufts Medical Center in Boston. First, a right L4-5 hemilaminectomy in 2023, then TLIF fusion of L4-5 in 2024. The laminectomy was worse pain wise initially. But I knew within 2 weeks it was a success. I couldn't walk more than 5-6 minutes before without excruciating pain. Afterwards, even while still on a walker, I could walk 30 minutes without any more than just some residual post-surgery discomfort. Post fusion, I never fully recovered from and that was 2 years ago.
The second opinion is from MGB (Mass General Brigham). Dr. Hadzipasic ordered all the tests and it was the CT scan that confirmed that L5 is the culprit. Could NOT see that on an MRI, so Tufts doctor was making an incorrect assumption based only on the MRI and not considering my symptoms, that I needed a laminectomy of the level above, L3-4.
Are you in PT? When was your surgery? It took me at least a year, and more like 18 months to feel any true relief, but now it's all back (no pun intended!) and then some. Where did you have your surgery? Have you been back to the surgeon to have more imaging done of the level of fusion along with above and below? MRI cannot see what's behind the fused area. Only a CT or Xray can, and of the two, the CT sees more. Second opinions can be helpful but if you go the route, be prepared for them disagreeing with the first surgeon. This happens almost always.
Good luck! Let me know how you are.

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