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L5/S1 Protrusion

  Below are the results from an MRI I recently had.  I have some tingling in
  my left leg as a result of the pressure on the sciatic nerve and little or
  no back pain. (AGE=32 yrs.)
  My questions are:
  1) What sports are to be avoided? (I enjoy raquetball, golf, x-country skiing,
  backpacking, kayaking, and some work with weights).
  2) Is the VAX-D treatment safe and/or effective?
  3) How easy is it to damage this disc further?
  4) Is desiccation the cracking of the disc?
  Thanks for your help..this is forum is a great idea!
  MRI of the Lumbar Spine: 11-19-98
  GE 1.5 Tesla Magnet. 3 sagittal and axial sequences T1 and fast spin
  echo images.
  At L5/S1 a left paracentral-lateral recess focal disc protrusion
  secondary to annular tear is noted.  The maximum width of the protrusion
  is approximately 1cm.  The disc protrusion is adjacent to the left S1
  nerve root.  No compression of the thecal sac or the nerve roots.
  L5 nerve roots are normal in position.  Bony reactive changes also
  noted involving the inferior end plate of L5 and the superior end
  plate of S1.  No spinal stenosis.  Partial desiccation of the L5/S1
  disc is also present.
  At L4/5 the disc configuration is normal.  Thecal sac and nerve roots
  are within normal limits.
  The L3/4 disc space is also within normal limits on the sagittal images.
  On the sagittal images the L2/3, L1/2 disc spaces are normal.
  Normal conus medullaris at L1.
  At L5/S1 partial disiccation of the disc.  Focal left paracentral-lateral
  recess disc protrusion is adjacent to the left S1 nerve root.  Altered
  signal in the end plates of L5 and S1 suggesting reactive.
Dear Sjelso,
You have a herniated disc at the L5/S1 level impinging on the left S1 nerve root.  The first line of therapy for a herniated disc is conservative.  The reason is that, given time, most discs will shrink in size and relieve the compression on the nerve root.  If a patient still have pain, numbness and/or weakness after 6-8 weeks of conservative therapy, surgery may be considered.
You are fortunate that you have only tingling in the leg.  A symptomatic disc at that level would cause pain in the calf on the left with variable numbness and weakness.  Your symptoms are mild.  In any event, you should continue to take it easy while the disc is shrinking down.  There is a continued risk to further disc herniation over time with an annular tear.  The only thing to prevent this would be to take it easy and not do vigorous, pounding activities.  Granted this is difficult to say to a young male.
Try to take it easy and, with luck, the disc won't cause you any further troubles.
Good luck.

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