Conversation: The conversation between human and AI assistant.
[|Human|] Yes, please make sence of my MRI ..... I am a 33 w/m and have already had 2 previous back surgeries at L5 for disk protrusions. I am currently in a lot of pain and this time it is not only isolated to L5, but T11-L1 also. Im wondering if another surgery would be beneficial. My last surgery was 2005 and was a success. 1.) T11-T12 disk protrusion with facet hypertrophy results in minimal canal encroachment. 2). T12-L1 left paracentral disk osteophytic protrusion results in very mild canal stenosis . Some minimal encroachment on the left neural foramen T12-L1. 3). L3-L4 There is mild broad based disk osteophytic bulge, without significant associated canal stenosis. Bilateral facet and ligamentum flavum hypertrophy contribute to mild bilateral neural foraminal stenosis. 4). L4-L5 There is broad base disk osteophytic bulge, without significant associated canal stenosis. Bilateral facet arthropathy and ligamentum flavum hypertrophy contribute to mild to moderate bilateral neural foraminal stenosis. 5). Postsurgical changes again noted with scarring and fibrosis in the right epidural space. There is residual extruded disk fragment inferiorly. There is associated moderate encroachment on the right lateral recess with moderate to severe right neural foraminal stenosis. Facet hypertrophic changes, with lateral disk osteophytic component additionally contribute to moderately severe left neural foraminal stenosis. Impression: Postsurgical changes at L5-S1 with a residual disk fragment inferiorly on the right, as well as fibrosis, with moderate to severe right neural foraminal stenosis. There is also moderate encroachment on the right lateral recess and moderately severe left neural foraminal stenosis at this level. There is mild canal stenosis at both T11-T12 and T12-L1 levels. There is mild to moderate neural foraminal encroachment bilaterally at L4-L5.
[|AI|]  Hi, Thank you for posting your query. Though you may benefit from surgery at L5-S1 disc level, it should be avoided or delayed. This is because surgery is not easy in patient who has already undergone two previous surgeries. The anatomy is distorted and only an experienced surgeon can succeed. Tere is no need for surgery at T11-T12 level, as the problem is minor. You should undergo physiotherapy and use medications such as pregabalin at present. Best wishes, Chat Doctor.