mandeepMemberAugust 12, 2012 at 2:48 pmPost count: 4
Dear Dr, I am 42 years old .since the past 3 years i have been having low back ache which has been intermittent.Since the last two weeks the pain is acute in the lower back ,more towards the left side .i have been unable to move much these last two weeks.i am on painkillers . Could you please offer your opinion on the MRI report .Thanks
MRI REPORT OF LUMBO – SACRAL SPINE
(Procedure : Sagital – T1 , T2, STAR; Axial – T1, T2; Coronal – STAR)
1. Partial loss of signal intensity of disc at L4 – L5 & L3 – L4 level……… Suggestive of degenerative change.
2. Early anterior end plate osteophytes at L3 to L5 vertebral bodies.
3. Mild diffuse disc bulge at L3 – L4 with mild compression upon thecal sac, no significant narrowing of neural foramina at this level.
4. Central and right paracentral disc bulge with left paracentral disc protrusion at L4 – L5 level seen with compression upon thecal sac and bilateral narrowing of neural foramina (left > right).
5. Conus medullaris ends at L1 level with normal cauda equina & medullaris.
6. Lower dorsal cord is normal in size and signal intensity.
6. Paraspinal muscles are normal in size and shape with normal signal intensity.
7. Focal end plate sclerotic change at upper end plate of L3 and early schromol’s node at upper end plate of L2.
8. Spinal canal dimension :
D12 – L1 – Level – Canal – APD 19.8 mm.
L1 – L2 – Level – Canal – APD 16.4 mm.
L2 – L3 – Level – Canal – APD 16.4 mm.
L3 – L4 – Level – Canal – APD 14.4 mm.
L4 – L5 – Level – Canal – APD 11.6 mm.
L5 – S1 – Level – Canal – APD 14.5 mm.Donald Corenman, MD, DCModeratorAugust 13, 2012 at 7:00 pmPost count: 8465
You have degenerative disc disease of L3-4 and L4-5. This can cause chronic lower back pain. You now have a disc herniation at L4-5 “Central and right paracentral disc bulge with left paracentral disc protrusion at L4 – L5 level seen with compression upon thecal sac and bilateral narrowing of neural foramina (left > right)”. This could explain your increased pain especially on your left side.
Dr. CorenmanmandeepMemberAugust 14, 2012 at 3:09 pmPost count: 4
Dear Dr, Thanks for your comments .In my case (degenerative), is the problem likely to aggravate in future ? Is surgery a solution ? ThanksDonald Corenman, MD, DCModeratorAugust 14, 2012 at 6:54 pmPost count: 8465
Any degenerative changes can continue. Many of these changes however really don’t matter in the long term. The degenerative changes that cause symptoms are the ones to address.
You are at the very beginning of the treatment cycle. As long as there is no neurological weakness of the leg muscles, you need basic treatment including physical therapy or chiropractic and possibly an injection. Read the thread “When to have lower back surgery” to understand surgical timing.
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