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  • taresh14
    Member
    Post count: 3

    Dr.Corenman,

    Hi , I am Taresh from India.I am 28 years old and have had backpain since 18yrs.Recently I got an MRI done and was diagnosed with l4-l5 and l5-s1 disc protrusion compressing anterior thecal sac and compressing left and right nerve root respectively.However the report and the image when compared appears the opposite.It looks like a posterior bulge.I have mild to sharp pain in my right buttock at times.My episode of pain appears only once in 4 months , when I practice martial arts , spin kicks and jump kicks.The back pain subsides in generally a week’s time.I am confused as to how to go about my back pain and rehab excercise because I am still confused to which side my bulge is.I am a pilot with the armed forces, flying transport aircraft and do run 5-6 miles daily when I am pain free.

    Please help.My MRI image/report is confusing.

    Thanks,
    Taresh

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Your back pain is probably from lumbar degenerative disc disease (DDD-see website). Martial arts put unusual torsion on the lumbar spine which will be noticed with lower back pain in some individuals who have DDD.

    You can help to reduce the torsion with core strengthening exercises. I recommend Pilates as this seems to be the best exercise to work the core muscles. It will take you three months to develop enough strength to be able to withstand these forces in martial arts.

    You do not have to worry which side the bulge is the greatest at this time as you don’t currently need interventional care. If time comes that you do need it, the injections should be on the side of greatest pain, not greatest pathology.

    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.
    taresh14
    Member
    Post count: 3

    Dr.Corenman,

    My concern is about the rehab/physio exercises I have to undertake.Do I have a posterior /anterior bulge ? Do I restrict myself to flexion/extension excercises? The report confuses me in this regard.
    The report says :

    1.Spinal curvature is maintained
    2.veterbral bodies show normal signal intensity
    3.height of vertebral bodies are normal
    4.Endplates showing normal signal intensities
    5.disc protrusion seen at l4-l5 compressing anterior thecal sac and traversing left nerve root
    6.disc protrusion seen at l5-s1 compressing anterior thecal sac and traversing right nerve root
    7.Disc hydration is lost at lower levels
    8.ALL n PLL are normal at all levels
    9.ligamentum flavum is normal
    10.bony spinal dimension is normal
    11.lateral recess is normal
    12.pre and para vertebral spaces are normal
    13.visualised cord is normal
    14.cord is seen to end at L1
    15.intervertebral neural foramina are normal
    16.visualised facets are normal

    Impression

    1.disc protrusion seen at l4-l5 compressing anterior thecal sac and traversing left nerve root
    2.disc protrusion seen at l5-s1 compressing anterior thecal sac and traversing right nerve root

    Kindly opine on the report and please do recommend the rehab excercise I need to undergo.My MRI images are available online.But unfortunately cant upload them here since it appears as spam when I try to do so.

    Thanks a lot.

    Taresh

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    The discs are bulged or herniated posteriorly. The way this is dictated sounds somewhat confusing but it really makes sense if you understand the anatomy. Since the nerve root sack (the dural sac) is posterior to these herniations, the ANTERIOR sac is effaced by these posterior bulges.

    These are typical disc herniations. You might also try epidural steroid injections if you find Pilates exercises are not as effective as you might like after three months.

    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.
    taresh14
    Member
    Post count: 3

    Dr.Corenman ,

    Thanks a lot for your reply.Can I have please have your email Id so that I could fwd u my MRI images for a better understanding of my anatomy.Your website posts links as spams.

    Thanks ,
    Taresh

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    You can send a message on the website and it will be picked up by my nurses and delivered to me. My nurses can give you information regarding delivery of images.

    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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