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Avatar universal

CT scan help!

Can someone help me understand these results - my doc just said it's osteoarthritis and wouldn't give me any idea of the long term implications - she just said she would expect these results from someone older (i'm 38) and i need to see a rheumatologist.  I got the appointment but must wait til April to see them...........  

At L4/5 the disc is degenerate with associated marginal osteophytes. There is again mild to moderate facet and ligamentous hypertrophy.  The combination causes some reduction in functional canal volume, although it remains within normal limits. There also appears to be moderate narrowing of both lateral recesses and there may or may not be some compromise of the L5 nerve roots.  There is also moderate to severe narrowing of the left exit with possible compromise of the left L4 nerve root.

At L5/S1 level the disc is degenerate with almost complete loss of disc height and some intra disc vacuum phenomenon. There are associated end plate changes and marginal osteophytes.  The osteophytes are particularly severe at the postural centra position where there is a large broad based disc osteophytes protrusion.  This contacts the theca and the right S1 nerve root in the right lateral recess with possible compromise or irritation.  There is again moderate narrowing of both exits, it seems slightly worse on the right and there may be right L5 nerve root compromise. Canal volume appears within normal limits.

Any help is much appreciated!
6 Responses
469901 tn?1276567223
I am so sorry you have to wait until April to see a rheumatologist!  I will try to help you with the little I know.  
Osteophytes are also known as bone spurs, bone or cartlidege protrusions.  They occur in joints affected by arthritis.
Degeneration and disc vacuum phenomenon are indicators of degenerative disc disease (DDD) which really is not a disease but a condition that almost all of us develop to some degree or another as we age.
Facet and ligamentous hypertrophy can be associated with spinal stenosis, which is a narrowing of the spinal canal.  This is often associated with DDD.

I am not much older than you and have some similar issues.  What symptoms are you experiencing?  Did they run any blood labs on you?  If so, do you have those results?
623944 tn?1244039090
Just going to add a little more to what txsilver said. On OA, the bone spurs develop as the disks thin and weaken to try to help stabilize the spine. The "associated end plate changes"

OA is becoming more and more common in younger generations because we sit at desks with very few breaks for hours at a time. It has become one of the main causes of OA in the "younger" generation.

As for long term - that depends a lot on you. The best thing you can do for your back is to strengthen your abdominal wall and your back muscles. But don't just start doing sit-ups and crunches! See a physical therapist so they can help structure an excersise program specifically for you. Take your CT scans/report with you. There are special strengthening exercises for people with OA of the spine that don't cause any further damage, you have to watch for that. Practice and try to implement good posture too. All that will help to prevent more damage.

Like txsilver, I'm interested in what symptoms your having. I have OA between L4/L5 & L5/S1 plus some bulging disks L3/L4 & L4/L5 so I may be able to help there too!
Avatar universal
Thank you both for your help.

I didn't know anything about this til a couple of months ago when I was moving house and ended up hardly able to walk or sit - I was in so much pain and my leg kept almost giving way under me. Thankfully that's stopped now but I'm still getting radiating across my lower back and kind of behind my hips.  I get a burning feeling if I walk for a while or try to walk quickly.  I've also started getting a really bad pain between and around one of my shoulders since I came back to work (desk job) I keep hoping the pain will settle down but am beginning to think I'm stuck with it. I seem to be really tired all the time too.
I haven't had any bloodwork done but about a year ago I had tests because I also suffer with migraines and mr ESR was elevated - the doc retested and it was still higher than normal but was a bit lower so the doc reckoned I'd had some infection a few weeks before.  
What symptoms do you have??  
469901 tn?1276567223
It's hard to say which symptoms go with which condition - I have several and they overlap.  I do have stenosis in my neck and degeneration in my lumbar and bulging disks there, too.  I have had some of the symptoms you listed and got relief from physical therapy, hot wraps or topical treatments (like stoppain or biofreeze) and massage.  Rest and lumbar support help, too.  Have you tried any of those?  I know it does not sound like much but it may help you get through to the rheumy appt.  Let us know how you are and if you find relief in anything you try.
623944 tn?1244039090
Your onst is very similar to mine, excruciating pain across the back & top of the hips....
Prednisone and muscle relaxers for a week helped me there. If it's still inflammed, then try some ice packs first, alternating with heat. The ice will help calm the inflamation which is most important, the heat will get blood flow to speed healing. It does go away, but it takes time. Your upper back is most likely hurting because of the strain on your low back. You've changed your posture and that is effecting the rest of your back muscles. Biofreeze also works for the muscle pain.
I also had a desk job, and for about 2-3 weeks, I had to have a bar stool to sit on because sitting in a normal chair was painful. The stool forced me to sit up straighter and that helped my back the most. Also, avoid lifting anything over 25 lbs until it heals. If you have to lift anything over 8 lbs from below your waist, bend at your knees, hold the object close to your stomach/chest, then lift. It keeps the strain off your low back, which will also help it heal. For long term care of the OA, just remember that whatever you lift while bending forward at the waist adds TONS of weight strain on your back, not pounds. If you don't remember to lift properly, you can cause the OA to get worse, and you could reinjure it.

Hope this helps!
745152 tn?1233147603
back and abdominal muscle strenghtening exercises with the help of a physiotherapist can help. also wear lumbo sacral belt for support during day time activity.nowadays spine surgeons do laproscopic disectomy and put stents for making room for canal narrowing.so consult a spine surgeon also in your area
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