lumbosacral Slr Finding Interpretations

[cannoncocker]

If someone that has experience with SLR findings could interpret this for me would be great and save a lot of digging and extrapolating:

Exam: SLR - + on L at 75 degrees; + contralateral at 75 degrees with pain to 1 leg.

LE DTR's - 2+ throughout

LE Motor: 4.5 5 1 Plantar Flex: otherwise 5/5 throughtout

LE Sens. - sl. decreased PP L lateral foot and left post. leg

babinski - down going toes bilat.

No ankle clonus

Toe Walk Mild weakness on L

Heel walk - nl

MRI

1. Alignment abnormalities, this degeneration and facet hypertrophy result in varying degrees of neural foraminal stenosis, as above. Disc material in the L5-S1 subarticular zone contacts the descending S1 Nerve Root and displaces it posteriorly towards the left facet.

2. Mild ventral deformity of the L1 ventral body with asscoiated kyphosis.

3. Mild focal levocurvature centered at the L4-L5. Minimal retrolisthesis of L4 on L5

4. diffusely hypointense marrow signal pattern most likely due to systemic stress.

lateral neural, flexion, and extension views of the lumbosacral spine are provided. Mild degenerative disease at multiple levels. there is stable grade 1 retrolisthesis at l3 on L4, and L4 on L5. this does not change on extension and there is approx. 1mm of correction on flexion views. at both levels. There is stable minimal antero-wedging on L1 with associated hyphosis. Smaill Osteophytes are again noted. No acute fracture.

Impression Grade 1 retrolesthesis at L3/L4 and L4/L5, does not change on extension, with approx. 1 mm correction on flexion views.

It has a bunch more history but this is the crux. Bilateral thigh numbness whic hot one has been able to isolate the orgin, but we are talking numb, not hurt, so I just roll with that, whatever the orgin.

They noted my options from meds to pt to epidural injections to surgery.

Any deciphering would be appreciated. I have some med. knowledge but this is pretty inside baseball for me.

Edited September 10, 2009 by cannoncocker

[deltaj]

If someone that has experience with SLR findings could interpret this for me would be great and save a lot of digging and extrapolating:

Exam: SLR - + on L at 75 degrees; + contralateral at 75 degrees with pain to 1 leg.

LE DTR's - 2+ throughout

LE Motor: 4.5 5 1 Plantar Flex: otherwise 5/5 throughtout

LE Sens. - sl. decreased PP L lateral foot and left post. leg

babinski - down going toes bilat.

No ankle clonus

Toe Walk Mild weakness on L

Heel walk - nl

MRI

1. Alignment abnormalities, this degeneration and facet hypertrophy result in varying degrees of neural foraminal stenosis, as above. Disc material in the L5-S1 subarticular zone contacts the descending S1 Nerve Root and displaces it posteriorly towards the left facet.

2. Mild ventral deformity of the L1 ventral body with asscoiated kyphosis.

3. Mild focal levocurvature centered at the L4-L5. Minimal retrolisthesis of L4 on L5

4. diffusely hypointense marrow signal pattern most likely due to systemic stress.

lateral neural, flexion, and extension views of the lumbosacral spine are provided. Mild degenerative disease at multiple levels. there is stable grade 1 retrolisthesis at l3 on L4, and L4 on L5. this does not change on extension and there is approx. 1mm of correction on flexion views. at both levels. There is stable minimal antero-wedging on L1 with associated hyphosis. Smaill Osteophytes are again noted. No acute fracture.

Impression Grade 1 retrolesthesis at L3/L4 and L4/L5, does not change on extension, with approx. 1 mm correction on flexion views.

It has a bunch more history but this is the crux. Bilateral thigh numbness whic hot one has been able to isolate the orgin, but we are talking numb, not hurt, so I just roll with that, whatever the orgin.

They noted my options from meds to pt to epidural injections to surgery.

Any deciphering would be appreciated. I have some med. knowledge but this is pretty inside baseball for me.

bilat. probably refers to bilaterally

L probably refers to left

DTRs probably refers to deep tendon reflexes.

LE possibly refers to left extremity

nl possibly refers to normal

post. posterior

SLR straoght leg raising

L3 lumbar 3

pp probably refers to pinprick

sens. possibly refers to sensory

sl possibly refers to sensation level

I don't know a lot but I recently took courses in anatomy and physiology, medical transcription, and medical terminology.

Edited September 11, 2009 by deltaj

[poolguy11550]

Strait leg raise

[cannoncocker]

Strait leg raise

Let me guess, you either lay around the pool a bunch or maintaina pool, which I think number 1 would be my first choice.

Thanks pool, for the reply, and i see you still get up early too. can't help it.

I am up on the acronym slr = Straight Leg Raise. more interested in the real world meanings in the findings and to what extent, if any, they hedged their interpretations.

Thanks Friend!

[poolguy11550]

I'll put on my VA raters thinking cap-

1. You have a mild to moderate back condition.

2. Based upon MRI findings, your back condition affects both your legs.

3. Your MRI findings show that some of your back condition is related to normal aging.

4. Physical exam correlates with the MRI findings.

If you are already S/C for your back then #3 is not concerning. If you are S/C for your back have you filed a claim for bilateral sciatica?

I am not a doctor so I cannot break down all the medical terms and give a diagnoses. I hope that this helps.

[cannoncocker]

I'll put on my VA raters thinking cap-

1. You have a mild to moderate back condition.

2. Based upon MRI findings, your back condition affects both your legs.

3. Your MRI findings show that some of your back condition is related to normal aging.

4. Physical exam correlates with the MRI findings.

If you are already S/C for your back then #3 is not concerning. If you are S/C for your back have you filed a claim for bilateral sciatica?

I am not a doctor so I cannot break down all the medical terms and give a diagnoses. I hope that this helps.

no to 1 they offered surgery for pinched S1 which is more than mild or moderare. Protruded/extruded discs. and epidural injections.

Degenerative disease is mild to moderate, so they say.

Degenerative disease MRI shows normal aging or at least some normal aging, depending which eval you look at. Wonder if carrying the projos far in excess of the NIOSH Lifting Equation played any part in this? Make a reasonable person consider that.

whether physician agrees is up to them i guess.

Denied after 6.5 years of field artillery lifting projos weighing 174 lbs across 100 yard repetitively.

The W-S VARO came to the conclusion which approximate= over my dead body.

Thanks though. DRO Hearing upcoming.

no to 2 (left only) but on slr move on rigt produces pain in left.

[deltaj]

no to 1 they offered surgery for pinched S1 which is more than mild or moderare. Protruded/extruded discs. and epidural injections.

Degenerative disease is mild to moderate, so they say.

Degenerative disease MRI shows normal aging or at least some normal aging, depending which eval you look at. Wonder if carrying the projos far in excess of the NIOSH Lifting Equation played any part in this? Make a reasonable person consider that.

whether physician agrees is up to them i guess.

Denied after 6.5 years of field artillery lifting projos weighing 174 lbs across 100 yard repetitively.

The W-S VARO came to the conclusion which approximate= over my dead body.

Thanks though. DRO Hearing upcoming.

no to 2 (left only) but on slr move on rigt produces pain in left.

First, I would point out that mild to moderate requires V.A. to assign the higher of two evaluations under 38 CFR 4.7 if service connection is granted. I do feel that for surgery to be recommended it must me at a somewhat advanced stage due to the decreased pinprick sensation. Are there any buddy statements you could get that would confirm in service injuries? You need copies of the recent exams and MRI to see what precisely was written about this condition.

Edited September 11, 2009 by deltaj