Q. Is nerve compression seen on my MRI or was it assumed because of pain?

Answered by
Dr. Chitrangada
and medically reviewed by Dr.Lekshmipriya B
This is a premium question & answer published on Jan 21, 2018 and last reviewed on: Jan 22, 2022

Hello doctor,

Ten months after hemilaminectomy at the L4-5 level, I suffered from severe pain in the lower back, which started radiating to the left leg. I have a diagnosis of arachnoiditis, arthritis, and low lying conus with fattening of filum terminale. Due to increasing pain and neuropsychologist recommendation, I was sent to do a new brain and L spine MRI, and I would like to hear your opinion on it.



Welcome to

I observed your scan (attachments removed to protect patient identity), and I agree that the conus is low lying at L2-L3 level (normally, it should end at L1 level). Facetal joint arthropathy is seen at multiple levels in the lumbar spine. Post-contrast images show abnormal enhancement of the anterior subarachnoid space consistent with arachnoiditis. However, the cause of your left side radiating pain is due to the left para-central disc bulge at L5-S1 level narrowing the neural foramina and compressing the L5 left exiting nerve roots. These changes are probably due to adjacent segment degeneration.

In my opinion, the MRI (magnetic resonance imaging) scan needs to be repeated post-therapy to see interval resolution of arachnoiditis. And also, if you can follow up with the clinical notes of the consulting physician, the imaging can be correlated to clinical exam findings. This professional advice I provided stands subject to the examination of the report or image and is based entirely on my inputs. It should be correlated with clinical findings.

Hello doctor,

Thank you for your reply.

I want to be sure that I understand. Does the MRI show that the L5 nerve is compressed, or is it something that is assumed because of the pain in the leg? The report from the hospital says that the L4 nerve is also compressed. Do you see that as well?



Welcome back to

The compression of the left exiting L5 nerve is significant. However, was the L4 nerve compression given in your pre-operative scans or postoperative as you underwent surgery at that level? Can you please follow up with your pre and postoperative scans for comparison?

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
I have spasms and pins and needles sensation in my hand. Please help.

Yes, football might have aggravated it by increasing the stress on the cervical spine ... An MRI of the cervical spine will help us understand the cause of symptoms ...   Read full

It is becoming hard for me to stand or be on my feet for a long time due to sciatica. Please help.

.. to understand the physiology of facet joints. It helps to have healthy movement and intervertebral disc provides stability for each motion segment. Aging, osteoporosis, and traumatic injury can damage facet joints and it is the leading cause of ba...   Read full

Please suggest some medicines for left-sided head, eye, cheek, and nose pain.

.. the following details. Do you have hypertension? Do you have a history of congestion and cold? Any history of stress, hypoglycemia, irregular meal, etc.? Do you have a throbbing pain? Do you have flashes of light and vomiting? If the answer is yes...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Monkeypox Virus - Symptoms, Diagnosis, Treatment, Complications, and Prevention
Monkeypox is a zoonotic viral disease. This virus got its name as it was first noticed in laboratory monkeys in the late...  Read more»
Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»

Ask your health query to a doctor online?

Ask a Radiologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.