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Back & Neck Pain  (Expert Forum)
 | 
MRIRESULTS EXPLINATION AND POSSIBLE TREATMENTS
Questions in the Back & Neck Pain forum are answered by Dr. Kwan Yin Chong and Dr. Prem Pillay. Topics covered include herniated disc, pinched nerves, sciatica, degenerative spine disease, spinal stenosis, spine trauma and fractures, and pine tumors.

MRIRESULTS EXPLINATION AND POSSIBLE TREATMENTS

by babygurl14311278, Jan 26, 2009 01:49PM
can someone help me understand these mri results and tell me possible treatment for this?

At L4-L5 there is mild disk desiccation and flattening. There is mild posterior annular tearing and dic protrusion present causing mild central canal narrowing and crowding of the subarticular portions of the bilateral L5 nerve roots. There is mild bilateral forminal narrowing secondary to disk bulging and endplate spurring as well.

At L5-S1 there is mild desiccation, flattening and bulging. There is superimposed mild posterior disc protrusion centrally which crowds the left S1 nerve root mildly. The neural foramina are minimally narrowed secondary to disc bulging and endplate spurring.  Degenerative disc disease and bulging L4-L5 and L5-S1 with small associated disc protrusions.

What does degenerative disc disease mean?
Any help understanding these findings and learning of treatment options would be greatly appreciated.

by Prem Pillay, MD, Apr 08, 2009 06:16AM
To: babygurl14311278
Your disc problems sound minor. You should benefit from  physiotherapy.
You may wish to visit my website for more spine info:  www.spine-neuro.org

sincerely yours

Dr Prem Pillay
Senior Neurosurgeon
NeuroSpine and Pain Center Singapore
Member Comments (5)

by Mage1970, Feb 02, 2009 11:10AM
To: babygurl
Don't have DegenDiscDea - Highly surprised to NOT SEE the word ARACHNOIDITIS
ask yor DR why HIS job is to make you aware of everything including FUTURE

by Sidddharthha, Feb 21, 2009 03:25PM
To: babygurl14311278
babygurl14311278,

Degenerative disc disease is the degeneration of your discs.  We are sll supposed to experience that as we age, some of us just have it happen more rapidly than others, and for us, it can mean the types of problems your MRI indicates.  I am not a doctor, just a person with DDD and multiple herniations, bulges, etc. causing excruciating pain.

Your MR results basically say those discs are deteriorating and bulging exerting pressure on the nerves coming out of those particular vertebrea.  I would expect you have significant stabbing pain around those areas.?  The L4-5 is in your lumbar spine, so that would be your lower back.

Lucky for you, lumbar herniations are very treatable.  You should take your MRI results to an Orthopedic Dr. who specializes in backs.  Many orthpedics only specialize in knees, shoulders, etc. so make sure he/she handles backs.  They should be able to suggest the right treatment for you.

Best of luck to you!

Sidddharthha

by scooby74, Feb 22, 2009 02:35AM
To: babygurl14311278
your spinal discs have degenerated and are protruding into the spaces where the nerves that supply your legs come off of the spinal cord. This is verrrrrrry common.

by Max1484, Feb 24, 2009 12:30PM
I found the information below very helpful in explaining the discs and how they work.  It is from a clinic in Chicago that does spinal decompress or vax-d.  I really liked the explanation - hope it helps you too.

The Discs
Discs have a very unique anatomy and, if you understand it, you will also understand why your back hurts in the first place.

The outside wall of each disc is called the “annulus.” It is made up of cartilage and, like the cartilage at the end of your nose, it is quite firm. The inside of the disc, however, is quite soft. It’s called the “nucleus pulposus.” It’s made up of a soft, jell-like substance. You’ll get the basic idea of a disc if you think of a jelly donut, or even a fried egg: firm on the outside, but soft and gooey on the inside.

The unique anatomy of the discs makes them terrific shock absorbers but, it also makes them uniquely vulnerable to injury.

Tears, Bulges Herniations and Ruptures

Little injuries or tears can weaken the outer wall of the disc allowing it to bulge out. Because the back of the disc actually has lots of nerves in it (called the “sinu-vertebral nerves”), this bulge can cause you lots of pain, and it frequently leads to severe muscle spasms and gripping back pain.

At other times, particularly if you have a traumatic injury, the disc tears suddenly and deeply. Think about what happens to a fried egg when you use your fork to break through the white part into the yolk. This is similar to what occurs if you tear the outer part of the disc or annulus.

If this tear goes all the way through the annulus, then the jell-like nucleus can actually ooze out. This is called a “herniation” or a “prolapse.” Some people call it a “ruptured disc.” When this occurs, the jell-like nucleus pulposis can actually end up putting pressure on the spinal chord or on the major nerve going down the leg, called the “sciatic” nerve. And, when this occurs, pain can radiate down into your buttocks and legs. You might also experience numbness, tingling, and weakness in your legs.

There are many ways that the disc can get injured, but once the nucleus pulposis oozes out, or dries up, the disc often flattens out and loses its ability to be a good shock absorber. When this happens, the joints at the back of your spine, called “facets,” can become jammed and inflamed, and this often causes constant achy-ness and stiffness. This is referred to as disc degeneration and frequently becomes arthritis of the spine.

Why Discs Don't Heal

There is another interesting fact about discs. Once you are about twenty-five years old, your discs no longer have a blood supply. The vertebrae of your spine do. In fact, almost all the bones in our body are nourished by a network of arteries and capillaries. That’s why our bones heal when we break them. However, there is no similar source of nutrients for adult discs. It is this lack of a blood or nutrient supply that makes it so difficult for injured discs to heal. Quite simply, after age twenty-five, it is very difficult for the nutrients and cells necessary for healing to get to the injured disc. So, unlike your bones, a disc will not heal on its own.

by bearhaven, Mar 25, 2009 03:25PM
To: Max
I have been doing a lot of research on this topic myself, what amazing and complicated bodies we have. I suffer with DDD also, I tried physio therapy after a fall 3 years ago where I impacted my tail bone sacrum and twisted my pelvis onto a metal wagon type cart at a nursery i use to work for.The pain was almost unbearable, it was like a tight pain band that went around my bum and hips and down my legs,getting out of bed was bad enough but within 2 hours had to go be flat again. Work safe tried to make me go back to work after 2 weeks calling it a lumbar strain, I adhered to their orders as they told me they would cut me off wage loss if I didn't at least try, I worked for 2 hours and then told them to cram it. I would see them in court, which i did win the case.Anyway the physio did not work , I found relief with regular visits 2 times a week to a chiropractor until my injured muscles could allow my spine to stay in place and then gradually turned it into once a month.
I did that for 8 months. I then went back into my health care job. I was fine until last May when I pulled a muscle in my thigh, limping around on that put my back out again, tried to return to work light duty, balance problems and the inability to bend even the slightest bit made me feel unsafe and unreliable to my clients,then depression left me feeling useless and within 3 days decided to quit. now I visit the chiropractor regularly, I still can't seem to get back to my old self. I've had bladder surgery due to incontinence, bowel endoscopy to determine nerve damage to my rectum and still my doctor yawns when i tell him it still is bothering me but never goes the next step to see what was wrong. he never  gave me anything for pain and it feels like I have to do all the research and tell him what to do.
since then my cervial (upper spine) has gone out .was in
a few head on collisions as a younger woman and now they are coming back to haunt me I woke up one morning with excrucruciating pain down my neck, back, shoulder, armpit ribs under my arm, down the arm onto the top of my hand and then into my fingers. heard about spinal decompression but its not covered here in canada and it costs 5000...soooooo I went in screaming at my doctor for something for pain, and to do something about my lower back.CT scans were taken and in my lower back I have a marked large herniation to my L4-L5 disc and  bulge at my L5-S1 with encroachment to the L4 nerve root and the L5 nerve root. On the upper part C4-5 mild disc bulge protrusion present on the anterior cord and c6-7 prominent DD end plate osteophytes, moderately severe bilateral foraminal encroachment.

My question is, arggggggggggggggggggggggggggggggg..lol
I have been told to have these injections in  my spine, scares me to death as I have heard horrible stories, should I shouldn't I?. I am now waiting for my doctor to get back from his holidays.
I am suppose to be seeing someone at the Vancouver general Hospital at the spine clinic to determine what should be done next, but again..... I am waiting waiting waiting..DOES ANYONE KNOW WHATS DON E IN THESE CASE WHEN EVERY OTHER AVENUE HAS BEEN EXHAUSTED..THANKYOU

BearHaven
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