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  • salmanasad
    Participant
    Post count: 2

    Hi Dr
    I have a history of bulge at L4-5 level 10 years earlier and I got fit by physiotherapy. Now in October 2019 I got another incident of Protrusion ant L4-5 and S1 level, I uderwent for physiotherapy but no relief. Moreover I was getting worse, so I went for another MRI on January 15, the report findings are as under:
    Screening images of the whole spine reveal loss of cervical lordosis. Degenerative spondylotic changes are seen in the cervical spine with marginal end plate osteophytes and degenerated intervertebral discs displaying hypointense signal on T2-weighted images. Diffuse disc bulges lead to thecal sac indentation from C4-5 to C6-7, more so at C5-6. The spinal cord is normal in bulk and signal intensity.
    OPINION: MR scan findings are suggestive of :-
    · Broad-based posterior disc protrusion at L5-S1 with right-sided propensity with a right paracentral disc extrusion, compromising the lateral canals, right > left and right intervertebral foramen with right asymmetrical traversing nerve root impingement.
    · Diffuse symmetrical bulge at L4-5, along with thickened ligamentum flavum, compromising the left intervertebral foramen without nerve root impingement.
    As compared to the previous MRI dated 31.10.2019, there is fresh right paracentral disc extrusion at L5-S1 that was not seen on the previous scan. The rest of the findings are unchanged. Please correlate clinically.
    Now I am taking Methylprednisolone 32 mg daily. Please suggest what is the right action for me.

    I have heard and read about you a lot and I believe I am at right place to get the answer of my problem.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    You note a “Broad-based posterior disc protrusion at L5-S1 with right-sided propensity with a right paracentral disc extrusion, compromising the lateral canals, right > left and right intervertebral foramen with right asymmetrical traversing nerve root impingement”. Then noted “compared to the previous MRI dated 31.10.2019, there is fresh right paracentral disc extrusion at L5-S1 that was not seen on the previous scan”.

    This means you have a larger disc herniation compressing the S1 and possibly the L5 nerve root on the right. Do you have motor weakness? See https://neckandback.com/conditions/home-testing-for-leg-weakness/ and https://neckandback.com/conditions/symptoms-of-lumbar-nerve-injuries/.

    Dr. Corenman

    salmanasad
    Participant
    Post count: 2

    Hi Dr. Thanks a lot for your very quick reply. The test you asked me to perform, I did and the results are:
    I tried to walk on my toes, I could manage but with difficulty, it was dropping and mostly the right foot. I also tried to stand on toes of right leg keeping left leg off the ground and could not stay longer, I tried to walk on my heels but my right leg was not working as good as my left leg. Please suggest how to move forward. Should I continue the medicine I am taking and wait and watch or should I go for any other test or investigation. Thanks a lot Dr once again.

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