Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
172 Doctors are Online

MRI of lumbar spine shows herniation that impinges upon theca sac. No back pain but pain in leg.

User rating for this question
Very Good
Answered by

General & Family Physician
Practicing since : 2004
Answered : 539 Questions
Question
I am trying to understand my MRI results of my lumbar spine. The summary reads as follows: A broad-based disc herniation at L4-L5 that impinges upon the theca sac and lateral recesses. At L5-S1, there is a large lobular disc herniation that appears to be more prominent on the right side. There is impingement upon the epidural fat and lateral recesses bilaterally, more prominent on the right side. It appears to abut the spinal canal at this level. I am a dancer by profession and am very worried about my ability to return to tour and continue my career. I have no pain in my back but have a heavy amount of pain in my right leg and my mobility is severely limited.
Posted Tue, 24 Apr 2012 in Brain and Spine
 
 
Answered by Dr. Sujeet N Charugulla 26 minutes later
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

Well, it looks like your current occupation would definitely not help with the condition that you wrote about. I am sorry, but if you have to live with this condition.

Ideally getting back to maximum healing after lumbar herniation that you seem to have, curtailing your career looks essential. Because, dancing does aggravate this and would prevent healing.

In fact, physical therapy is advised as second line in management by your doctor only after rest and alteration of the lifestyle has happened. The analgesic given would take care of your agony in the leg muscles for now and also relieve the spasm surrounding the muscles of the lumbar spine.

It would be some months of real rest away from dancing before your doctor who has seen you can comment if you can get back on stage or not, but till then you need to give a break in your profession.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Sujeet N Charugulla, MBBS, MD
Consultant Physician.
Above answer was peer-reviewed by
 
Follow-up: MRI of lumbar spine shows herniation that impinges upon theca sac. No back pain but pain in leg. 41 hours later
I understand that rest is necessary, dancing is really not possible right now. What I am asking is for you to explain the MRI results to me. From a medical perspective, what are the most logical steps so that I may return to my career at some point. Just PT? Will these herniations return to normal on their own? I plan to be out for some time. My body can only walk right now and even that is with a great deal of pain. I would however like to understand what is happening to my body and what I can do aside from rest to speed up the healing process.
 
 
Answered by Dr. Sujeet N Charugulla 22 hours later
Thanks for your reply.

Your MRI explanation:
A broad-based disc herniation at L4-L5 that impinges upon the theca sac and lateral recesses. (Herniation happens due to giving way of the membrane holding the disc, and impinging on neighboring structures/spinal cord within the theca etc, this is the 1st herniation)
At L5-S1, there is a large lobular disc herniation that appears to be more prominent on the right side. (2nd herniation down below the 1st)
There is impingement upon the epidural fat and lateral recesses bilaterally, more prominent on the right side. It appears to about the spinal canal at this level.
(2nd herniation is not pressing the thecal sac like the 1st, hence is a little better than the 1st grossly speaking.)

Apart from the strict adherence to the pattern of bed rest and activity as suggested in writing from the orthopedic surgeon, there is nothing else that would provide you additional benefits to return back your lifestyle. For dancing, you would need a perfect spine, which in my knowledge would be rather difficult to say as I have to tell you only on the basis of MRI without even examining you.

Yes, minor ones (your's seems minor) do heal in 2-3 months with other NSAID medications and treatments.

Tested options to speed up recovery in the long term: (apart from PT)
proper body mechanics training, Weight normalcy, Smoking Tobacco cessation, Lumbosacral back support with paddings etc.

Hope I have been able to answer your query this time. Please revert back if you have any further queries.

Wishing you good health.

Sincerely,
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Topics

The user accepted the expert's answer

Ask a Neurologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor