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Lower back/spine problem.
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Lower back/spine problem.

Can someone please explain these results to me and tell me what the possible long term implications are.  Im quite active, i play rugby, basketball and footbal.  Is it likely i will be able to play them again?

The MRI results......

Indications: Lower back pain.

Findings:
At L5/S1 intervertebral disc level there is diffuse posterior disc bulge with bilateral mild facet hypertrophy that indents the thecal sac.  No significant nerve root compression noted though bilateral mild inferior foraminal stenosis is noted.
At L4/5 intervertebral disc level there is diffuse posterior disc bulge and some of the disc material is in the extradural space and measures 13mm in the superior inferior measurement and 8mm in anterior posterior measurement.  It indents the thecal sac anteriorly.  Thjere is bilateral mild foraminal stenosis inferiorly caused by the disc bulge and bilateral mild facet hypertrophy.  At remaining levels no disc bulge perfusion or cord compression.

Impression:
1. L4/5 posterior disc bulge with mild extrusion of the disc material in the extradural space.
2. L5/S1 disc bulge as well.  bilateral mild foraminal stenosis at this level.
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Avatar_m_tn
Ok, the spine’s made up of several bones, called vertebra and their numbered L1-2 and so on. In between these vertebra are spinal discs, they act as shock absorbers or cushions in the spine. As we age we can develop arthritis and our disc degenerate, shrink and sometimes bulge. Which just means that they stick out further than normal. Worse case scenario is a herniation that has ruptured.

At L5/S1 intervertebral disc level there is diffuse posterior disc bulge with bilateral mild facet hypertrophy that indents the thecal sac.  No significant nerve root compression noted though bilateral mild inferior foraminal stenosis is noted.

So at L5/S1 level you have a small disc bulge with bilateral mild facet hypertrophy  ( the facet joints connect all of the vertebrae and allow coordinated movement of the spine) Hypertrophy means (the wearing down of the cartilage and enlargement of the bones forming the joint) indent means ( thinning or wearing down) the thecal sac (.encases the spinal cord and contains fluid to protect and feed the nerves) No significant nerve root compression means that your spinal nerves at this level are not being significantly compressed by the disc bulge or the arthritis of the facet joints.  Mild foraminal stenosis (the foramina is where the nerve roots come through from the spinal canal, sometimes a disc bulge or arthritis can pinch the nerve causing pain) what this is saying is that you have mild (minor) foraminal stenosis means narrowing.

Put it all together you have a small disc bulge at L5-S1 and you have mild (minor) arthritis of the facet joints mildly pressing on the thecal sac and causing minor foraminal narrowing. There are no major problems here.

At L4/5 intervertebral disc level there is diffuse posterior disc bulge and some of the disc material is in the extradural space and measures 13mm in the superior inferior measurement and 8mm in anterior posterior measurement.  It indents the thecal sac anteriorly.  Thjere is bilateral mild foraminal stenosis inferiorly caused by the disc bulge and bilateral mild facet hypertrophy.  At remaining levels no disc bulge perfusion or cord compression.

You pretty much have the same thing going on at this level, except that the disc has ruptured and part of it gone into the extradural space which is ( the outermost part of the spinal canal in which the nerve roots past through) It’s also compressing the thecal sac a little. You also have mild facet joint arthritis and the foramen is being narrowed mildly. The report further states that you have no problems at any other level.

L4-5 is where your problems is, the disc has ruptured and the disc material has gone into the extradural space. The concern here is that it might injury one of your nerves, however the finding is mild.

The Surgeon’s going to have to look at your MRI and decide whether surgery is actually necessary. A Family doctor really isn’t really knowledgeable enough to make that determination. I imagine you’re pretty stressed about all this, try to hang in there. I know what you’re going through; I’ve been through it myself.

Good luck with everything and keep us posted.
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5 Comments Post a Comment
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Avatar_m_tn
Exactly what type of pain are experiencing from this, and what are your Doctors recommending? What treatments have you had?
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Avatar_n_tn
It feels like an aching muscular pain, but it’s not going away.  My back also seems a lot weaker than it used to be, especially when I am bending over i can feel myself using my stomach muscles to pull myself back up.  At times the pain is slightly worse than others and every week or two I’ll get a pain going down my thigh.  It does not tend to last for long, minutes rather than hours, and it's so slight that sometimes I think my mind is playing games on me.
The Dr has referred me to see the spinal specialist and she said that its like they will have to do surgery because I have ruptured one of the "core" something in my back and the fluid is leaking out which is what’s causing the pain.  She said that once the core is ruptured it does not heal itself.
So far she has gave me diclofenac (SR 125mg) to take once a day and some muscle relaxants which didn’t seem to do anything and I've had a few physio sessions, approx 6, which once again didn’t seem to do anything.

Are you able to explain any of the results to from the MRI to me further?
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Avatar_m_tn
Ok, the spine’s made up of several bones, called vertebra and their numbered L1-2 and so on. In between these vertebra are spinal discs, they act as shock absorbers or cushions in the spine. As we age we can develop arthritis and our disc degenerate, shrink and sometimes bulge. Which just means that they stick out further than normal. Worse case scenario is a herniation that has ruptured.

At L5/S1 intervertebral disc level there is diffuse posterior disc bulge with bilateral mild facet hypertrophy that indents the thecal sac.  No significant nerve root compression noted though bilateral mild inferior foraminal stenosis is noted.

So at L5/S1 level you have a small disc bulge with bilateral mild facet hypertrophy  ( the facet joints connect all of the vertebrae and allow coordinated movement of the spine) Hypertrophy means (the wearing down of the cartilage and enlargement of the bones forming the joint) indent means ( thinning or wearing down) the thecal sac (.encases the spinal cord and contains fluid to protect and feed the nerves) No significant nerve root compression means that your spinal nerves at this level are not being significantly compressed by the disc bulge or the arthritis of the facet joints.  Mild foraminal stenosis (the foramina is where the nerve roots come through from the spinal canal, sometimes a disc bulge or arthritis can pinch the nerve causing pain) what this is saying is that you have mild (minor) foraminal stenosis means narrowing.

Put it all together you have a small disc bulge at L5-S1 and you have mild (minor) arthritis of the facet joints mildly pressing on the thecal sac and causing minor foraminal narrowing. There are no major problems here.

At L4/5 intervertebral disc level there is diffuse posterior disc bulge and some of the disc material is in the extradural space and measures 13mm in the superior inferior measurement and 8mm in anterior posterior measurement.  It indents the thecal sac anteriorly.  Thjere is bilateral mild foraminal stenosis inferiorly caused by the disc bulge and bilateral mild facet hypertrophy.  At remaining levels no disc bulge perfusion or cord compression.

You pretty much have the same thing going on at this level, except that the disc has ruptured and part of it gone into the extradural space which is ( the outermost part of the spinal canal in which the nerve roots past through) It’s also compressing the thecal sac a little. You also have mild facet joint arthritis and the foramen is being narrowed mildly. The report further states that you have no problems at any other level.

L4-5 is where your problems is, the disc has ruptured and the disc material has gone into the extradural space. The concern here is that it might injury one of your nerves, however the finding is mild.

The Surgeon’s going to have to look at your MRI and decide whether surgery is actually necessary. A Family doctor really isn’t really knowledgeable enough to make that determination. I imagine you’re pretty stressed about all this, try to hang in there. I know what you’re going through; I’ve been through it myself.

Good luck with everything and keep us posted.
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Avatar_n_tn
Kalvin, Thanks very much for explaining.  Is it likely i will have long term pain from this or will I recover fully? do you think i will be able to play sports again?  Im still young, only 25!
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Avatar_m_tn
First you have to see if this Doctor recommends surgery, are you going to be seeing him/her soon?

Even if you have to have surgery, you should be able to make a good recovery, because you're young and also because you don't have a ton of things wrong with your back. What do you do for a living?
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