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Suffering from chronic back pain. Disc herniation. What is he possibility of Ankylosing Spondylitis?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 9086 Questions
I have chronic back pain (intermittent past 16 years) . I am looking for a professional to review/assess my imaging (X-rays & MRI) and explain/report on what it means and what medical condition / disease may be present and where. Also I am concerned RE the possibility of Ankylosing Spondilitis and would like to know if the condition / shape of vertabrae show any indications in that direction and also if there is any sign of sacroiliitis / fusion of the SI joint.
I am aware of the disc dessication aswell as the disc herniation at L4/L5 and L5/S1 and the pressure they exert on the spinal nerves.
Posted Mon, 21 May 2012 in Back Pain
Answered by Dr. Praveen Tayal 1 hour later
Thanks for writing in.
I have gone through your reports and would like to make the following comments:
Firstly, the images are suggestive of a reduced disc space between L4-5 and L5-S1 which is causing the nerve root compression, which is thereby leading to the back pain.
Secondly, these changes are not spondylotic in nature and ankylosing spondylytis is not a likely possibility
Next, there are no findings suggestive of fusion of sacroiliac joints either.
Finally, the changes in the lumbar spine can be age related degenerative changes which is causing herniation of the discs. With proper physiotherapy and improvisation of posture, these minor changes can be reverted back to normal.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Suffering from chronic back pain. Disc herniation. What is he possibility of Ankylosing Spondylitis? 40 minutes later
Hello Dr Tayal and thanks for your review of my medical reports.

How about the shape of the end plates on some of the vertabra? (for example the L1/L2 endplates and others) as shown on the MRI images (see S03_T@w_FS_Image05.jpg in my reports).
They don't look very flat (concave?) and the right-side edges are coming awfully close to each other. I was wondering what this kind of shape was indicative of - is it normal/abnormal etc. Can you please shed some light on that?

Many thanks,

Answered by Dr. Praveen Tayal 3 hours later
Thanks for writing again.
I have seen the image you have mentioned.
I do not feel that the end plates of the vertebrae L1-L2 or other vertebrae have any abnormality. This is just a normal variant of the end plate. These minor variations do not feel concerning. The close edges that you are seeing are not entirely the bone ends. These do include the soft tissues also. The lateral view of X- XXXXXXX makes the bony outline clear.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.

Above answer was peer-reviewed by
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