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Neck Pain & Low Back Pain. Right-sided Pain. Evaluate for disc Herniation

Neck Pain & Low Back Pain. Right-sided Pain. Evaluate for disc Herniation

Here is my MRI Report
age:35, sex: male

HISTORY: Low Back Pain. Right-sided Pain. Evaluate for disc Herniation

FINDINGS: There is straighening of the mid to upper lumbar lordosis, suggesting muscle spasm or sprain. There is a schmorl's node formation at the superior endplate of L4 and some endplate signal changes inferiorly at L3. The vertebral marrow signal is otherwise unremarkable. Mild disc space narrowing is at L3-4. The other disc space heights preserved.Some disc desiccation occurs at L2-3 and L3-4. The vertebral body heights are maintianed. The conus appears unremarkable and ends near L1-2.
At T12-L1, there is a mild broad disc bulge, but more prominent centrally. The L1-2 disc is unremarkable.L2-3 shows some mild broad disc bulging. The L3-4 level contains a central disc protrusion with superimposed broad disc bulging. Foraminal narrowing occurs on the bilaterally.

At L4-5, a broad disc bulge flattens the thecal sac and combines with posterior elements to narrow both neural foramina. L5-S1 contains a broad disc bulge. No spinal stenosis or paraspinous mass is present.

1. Central disc protrusion at L3-4.
2. Disc bulges occur at T12-L1 and L2-3 to L5-S1.
3. Foraminal narrowing occurs on both sides at L4-5 and L3-4 , with clinical correlation recommended for corresponding radiculopathies.
4. Straightened lumbar lordosis suggests muscle spasm or sprain.


HISTORY: Neck Pain. Evaluate for disc Herniation

FINDINGS: There is diffuse straightening of the expected cervical lordosis, suggesting muscle spasm or sprain. Some disc desiccation and mild disc space narrowing are at C5-6 and C6-7. The other disc space heights are preserved. The vertebral body heights are maintianed. The cervical cord contains no intramedullary mass. The visualized posterior fossa structures are unremarkable.

The c2-3 and C3-4 discs are unremarkable. C4-5 has a mild broad disc bulge,which indents the thecal sac. The C5-6 level has broad disc bulging,along with some endplate and uncovertebral spurring. Disc contacts the anterior cervical cord diffusely. Foraminal stenosis occurs on both side. The C6-7 level has a broad disc bulge and some uncovertebral spurring. Disc approaches the cervical cord and narrows both neural foramina. The C7-T1 and T1-2 discs are unremarkable.

1. Disc bulges occur at C4-5 to C6-7.
2. Disc contacts the cervical cord at C5-6 and approaches it at C6-7. This represents spinal stenosis at the C5-6 level.
3. Bilateral foraminal stenosis occurs at C5-6 with foraminal narrowing on both sides at C6-7. Clinical correlation is recommended for corresponding radiculopathies.
4. Straightened  cervical lordosis suggests muscle spasm or sprain.

What do I need to go for ? My Doc recommends surgery Please Help Me.

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3 Comments Post a Comment
Avatar n tn
Hi Raj,
How are you feeling? Why have you got the scans done?
Your report suggests that you have spinal disc pathology.
Initial symptoms of which is usually nerve root pain. Nerve Root Pain - nerve root pinching / irritation / compression / trapping is always associated with signs of nerve dysfunction (not working properly) such as pain, tingling, numbness, and weakness.  
The causes of the irritation are: - within the spine Annular Tear (small disc tear), Disc Prolapse (herniation), Spinal Stenosis (narrowing of the internal diameter of the spinal canal) among others. Spinal Nerve Root Pain (Radiculopathy) can arise when nerves become pinched or trapped within the bony spinal canal or vertebral column:-
C4 to T1 nerves in the neck cause Brachialgia in the shoulder and arm.
There are many different terms used to describe spinal disc pathology and associated pain, such as “herniated disc”, “pinched nerve”, and “bulging disc”. The bones which form your spine are called as vertebrae. The space between two vertebras is cushioned with disc. When disc bulge or break open due to any reasons like ageing (aging), or trauma to spine, it is called as herniated disc and this can cause pinching of nerve. It can happen in any region, but is more common at lower back in lumbar region and cervical region.
It is advisable for you to do physiotherapy for relief of pain and spasm of muscle, pain killers and pain management specialist for conservative management.
But if this fails, the option left is surgery.
You can try a Transcutaneous Electrical Nerve Stimulator, which is an electronic device that produces electrical signals used to stimulate nerves through unbroken skin. The unit is usually connected to the skin using two or more electrodes. TENS works to decrease pain perception and may be used to control acute and chronic pain. It helps in regenerating nerve.
Nerves regenerate, or heal, at a rate 1 millimeter/day. The only nerves that can regenerate are the nerves outside of the spinal cord, or peripheral nerves. The nerves in the spinal cord, once damaged, cannot regenerate. However, if the peripheral nerve is severely damaged or stretched it may never heal.
You may want to consider surgery if you have had severe shooting pain in hips radiating down to foot for more than a month. Only about 1 person in 10 still has enough pain after 6 weeks to think about surgery.
As there are complications associated with spinal surgery, the doctor will exhaust all his conservative management and then opine for surgery.
Discectomy, Laminotomy, Laminectomy or percutaneous laminectomy are usually considered surgeries.
Keep me informed about your decision and also regarding your discussion with your surgeon
Hope this helps.
Avatar n tn
Thakns Caliber! Its a good information. I had this MRI done for shooting pain in right lower back pain,hip region,along right leg,to the right foot.. Its been their for more than 6 mnths. Its coming and going. Rightnow ,I'm doing everyday streching and yoga back execricise. It reliefs for couple of hours. After sitting 8-10hs infornt of computer and while driving back to home, I'll feel that pain again.
These are temporary relief. Can I heal this damage without surgery? I'm scared of surgery, many people suggests surgery are not 100% fix. In my case , what will be recommended?

I have appt next week with neurologist again. Let you know what she can suggests me?

Avatar n tn
Hi Raj,
How are you feeling now?
Raj, I feel you are taking outmost care to manage it conservatively. You have been through this pain from last 6 months. You have diagnosed as having herniated disc and other spinal disc pathology. Still the symptoms are annoying you.
Managing without surgery at this stage would be less likely. I think you need to intervene surgically, but before giving consent for surgery, you should know all benefits of surgery, percentage of your ailment getting better, complication associated with surgery and how frequently will be your follow-ups.
You also need to ask about overall plan of management for your ailment.
Yes, no surgeon would guarantee 100% cure, but you need to see what is beneficial for you, medical line of management or surgical line of management.
I feel you should go in for surgery after discussing pros and cons with your operating surgeon.
Keep me informed about your discussion with your surgeon.
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