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  • Eric
    Participant
    Post count: 6

    Hi Dr. Corenman,
    I have consulted with you in the past (several years) regarding my upper cervical degeneration. In the past 16 months I started developing lower back pain as well. It worsened over the months until it is now a constant steady pain, but does not interfere with walking or any bodily functions. What would be your initial thoughts about urgency on this CT scan diagnosis/report be? Any observations that jump out at you?

    At L5-S1, the spinal malalignment at this level results in a partially uncovered intervertebral disc. Schmorl’s nodes are identified within the L5-S1 vertebral endplates. There is mild stenosis of the spinal canal. The uncovered disc is in close proximity to the bilateral traversing S1 nerve roots. There is disc osteophyte encroachment upon the bilateral neural foramina contributing to moderately severe neural foraminal stenosis. Impingement of the exiting right-sided L5 nerve root is suspected. There is also potential for impingement of the exiting left-sided L5 nerve root.

    CT LUMBAR SPINE: There is approximately 9 mm of retrolisthesis of L5 on S1. At L4-5, there is moderately severe central spinal canal stenosis with evidence of thecal sac compression. At L5-S1, the partially uncovered intervertebral disc is in close proximity to the bilateral traversing S1 nerve roots. There is evidence of moderate bilateral neural foraminal stenosis at this level secondary to disc-osteophyte encroachment. Impingement of the exiting right-sided L5 nerve root is suspected. There is also potential for impingement of the exiting left-sided L5 nerve root.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8018

    I’m not clear what a “partially uncovered intervertebral disc” is. “Mild stenosis of the spinal canal” at L5-S1 if normally not a significant problem. This is more significant; “moderately severe neural foraminal stenosis. Impingement of the exiting right-sided L5 nerve root is suspected. There is also potential for impingement of the exiting left-sided L5 nerve root” This could cause an L5 stenotic root pain. The disc at this level is very degenerative “There is approximately 9 mm of retrolisthesis of L5 on S1” which could cause significant lower back pain.

    This could cause neurogenic claudication. “At L4-5, there is moderately severe central spinal canal stenosis with evidence of thecal sac compression”.

    See;
    https://neckandback.com/conditions/isolated-disc-resorption-lumbar-spine-idr/
    https://neckandback.com/conditions/foraminal-collapse-lumbar-spine/
    https://neckandback.com/conditions/lumbar-spinal-stenosis-central-stenosis/

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Eric
    Participant
    Post count: 6

    Thank you for the reply. “partially uncovered intervertebral disc” certainly wasn’t clear to me. Would I be correct is assuming that L5-S1 fusion surgery would likely be the ultimate resolution for this level of stenosis?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8018

    It really depends upon your symptoms and a diagnostic workup. You might just need a decompression and not need a fusion.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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