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What does "Disc degeneration at L5-S1, with bilateral spondylolysis"mean?

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General & Family Physician
Practicing since : 2001
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I got my MRI results and need help understanding it: There is exaggerated lordosis At L5-S1 there is disc degeneration with desiccation of disc material and loss of normal T2 signal and disc space thinning. Bilateral spondylolysis is suspected, with facet arthropanthy observed. There is mild anterolisthesis of L5 on S1, grade 1 spondylolisthesis. There is diffuse disc bulging more prominent in the left pericentral. Within the bulging disc material is curvilinear T2 signal hyperintensity, suspect an annular tear. There is moderate bilateral foraminal stenosis, greater on the left. There is relative mild narrowing of the spinal canal with disc material abutting the thecal sac and the S1 nerve root origins, without significant mass effect on these structures. The remaining disc spaces are maintained, with normal hydration, without focal protrusions or herniations. There is facet arthropathy identified at L4-L5 and to a lesser degree L3-L4. There is moderate bilateral foraminal narrowing appreciated at L4-L5. Normal marrow signal is noted in the bony structures of the lumbar spine. Particulary, there is no evidence of fracture or bone marrow edema. There is no marrow replacement process. There are no signal abnormalities identified in the distal cord or conus medullaris region. Impression: 1) Disc degeneration at L5-S1, with bilateral spondylolysis suspected with grade 1 spondylolisthesis of L5 on S1. Diffuse facet arthropathy. Diffuse disc bulging with relative mild narrowing of the bony spinal canal, without spinal significant canal stenosis. Annular tear suspected in the bulging disc, left paracentral. 2) Facet arthropathy at L4-L5 with relative mild to moderate bilateral foraminal narrowing. 3) Exaggerated lordosis
Posted Fri, 21 Feb 2014 in General Health
Answered by Dr. Michelle Gibson James 57 minutes later
Brief Answer: different issues seen Detailed Answer: Hi, thanks for using healthcare magic I am going to go into the anatomy of the back a little first. The bones in the back are called vertebra. There are the cervical vertebra (in the neck), the thoracic vertebra (chest area) and the lumbar vertebra (in the lower back). There are five lumbar vertebra, after the 5th lumbar vertebra , there is the sacrum. In between any two vertebra are intervertebral discs. These discs are made up of an outer ring called the annulus fibrosus and an inner part called the nucleus pulposus. These intervertebral discs help to distribute the pressure or force in the back and also act as shock absorbers. There are made up of a gel like substance and therefore have a high water content. YOUR RESULTS (1) lordosis refers to excess inward curvature of the lower spine. It can occur due to different causes. IF you want to picture it, envision a heavy pregnant woman curving her lower back forward to support her abdomen. (2)Disc degeneration between the Lumbar vertebra 5 and the sacrum- this refers to the intervertebral discs mentioned before. These intervetebral discs can degenerate/ break down due to different reasons. When they do, they cannot work as before. In addition, tears in the outer ring ( the annulus fibrosus) can cause the nucleus pulposus to bulge out (as mentioned in your result). This bulging can sometimes affect surrounding spinal nerves or the spinal canal (the space in the center of the vertebra where the spinal cord passes). In your case they note that though there is bulging there is not significant narrowing of the spinal canal so it is not compressing the spinal cord. LEft paracentral means on the left central aspect of the vertebral space. (3)spondylosis refers to arthritis of particular aspects of the vertebra (4)facet arthopathy- the facet joints are where the vertebra meet. Facet arthropathy means there are arthritis changes here as well. As a result of these changes there is narrowing of the foramin canal between lumbar vertebra 4 and 5.The foramen are openings where nerves branching off from the spinal cord pass through. This narrowing, if the nerves are compressed would possibly cause tingling, numbness, weakness, abnormal sensations. (5)spondylolistheis means one vertebra is displaced over the other or not in the correct alignment over the other. Your L5 vertebra is displaced slightly over the sacrum I hope this helps, feel free to ask any additional questions
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Follow-up: What does "Disc degeneration at L5-S1, with bilateral spondylolysis"mean? 11 minutes later
Is this "bad"? I have pain down both legs and also buttocks and hips (usually burning type) What does the "T2 signal loss" refer to?
Answered by Dr. Michelle Gibson James 31 minutes later
Brief Answer: t2 refers to fluid loss Detailed Answer: HI These changes would definitely cause pain and abnormal sensations in the buttocks and limbs. The t 2 signal loss reflects dehydration or decrease fluid content of the discs. Decreased fluids in the discs can cause the tears and bulging seen. There are a lot of different changes ( disc bulging, spondylosis, spondylolisthesis, facet arthropathy, narrowing of the foramen) , taken together, it is 'bad' in terms of the level of discomfort you may feel. At this stage however, your doctor may only recommend pain therapy and physiotherapy. Please feel free to ask anything else
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