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What Does MRI Showing Disc Degeneration At L5-S1 Indicate?
Question: I had a MRI done and it showed that at L4-L5 bilateral facet jount hypertrophy is present. L5-S1 there is asymmetric protrusion of disc material centrally and to the right with ligamentum flavum hypertrophy and facet joint hypertrophy. Narrowing of the neural foramina bilaterally. Findings suggest probable neural impingement of the exiting nerve roots at L5-S1 on the right. I have been suffuring from back pain and leg numbness for over 3 years now. What would be recommended
Brief Answer:
First medications and then surgery
Detailed Answer:
Hi XXXXXXX ,
Thanks for writing in to us.
I have read your query in detail and sorry to hear about your pains.
You are having disc degeneration at two levels in your lower back region.
At first I would like to make you understand the anatomy of the backbone. There are small bones aligned on top of each other which makes up the vertebral column. Between these small bones there is a spongy disc at each of the levels. The spinal cord runs from the neck to lower back in a canal on the back side of the vertebral column. At each level we have nerves leaving the spinal cord and supplying the rest of the body and these nerves pass through small holes between these bones called foramina.
When a particular bone or disc shows degenerative changes, the disc is often displaced backwards or sidewards and this is called protrusion or herniation. The displaced discs cause pressure over the nerves leaving through the small holes on either side leading to pain. The severity of pain depends on the pressure of the displaced disc on nerve roots. Other changes like joint hypertrophy and ligamentum flavum hypertrophy further increases the pressure on the nerves.
You are having above mentioned problems at two levels L 4 - L 5 (both sides) and L 5 - S 1 (right side). It is not mentioned as severe but I agree that you are in a lot of pain and discomfort, this is subjective and varies in each patient.
Initially medical treatment must be taken starting with mild pain killers and if they do not give relief then heavy pain killers and neurogenic pain relievers must be taken. Medical treatment can be tried for few months to years. Physiotherapy may also help in some cases. The patient must also avoid heavy physical activities for a while. If the pain is persistent even after years of medications then the disc fragments can be surgically removed an the pressure on nerves reduced which will then give relief. Laser assisted surgery is also done these days at some hospitals and the results have been good.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
First medications and then surgery
Detailed Answer:
Hi XXXXXXX ,
Thanks for writing in to us.
I have read your query in detail and sorry to hear about your pains.
You are having disc degeneration at two levels in your lower back region.
At first I would like to make you understand the anatomy of the backbone. There are small bones aligned on top of each other which makes up the vertebral column. Between these small bones there is a spongy disc at each of the levels. The spinal cord runs from the neck to lower back in a canal on the back side of the vertebral column. At each level we have nerves leaving the spinal cord and supplying the rest of the body and these nerves pass through small holes between these bones called foramina.
When a particular bone or disc shows degenerative changes, the disc is often displaced backwards or sidewards and this is called protrusion or herniation. The displaced discs cause pressure over the nerves leaving through the small holes on either side leading to pain. The severity of pain depends on the pressure of the displaced disc on nerve roots. Other changes like joint hypertrophy and ligamentum flavum hypertrophy further increases the pressure on the nerves.
You are having above mentioned problems at two levels L 4 - L 5 (both sides) and L 5 - S 1 (right side). It is not mentioned as severe but I agree that you are in a lot of pain and discomfort, this is subjective and varies in each patient.
Initially medical treatment must be taken starting with mild pain killers and if they do not give relief then heavy pain killers and neurogenic pain relievers must be taken. Medical treatment can be tried for few months to years. Physiotherapy may also help in some cases. The patient must also avoid heavy physical activities for a while. If the pain is persistent even after years of medications then the disc fragments can be surgically removed an the pressure on nerves reduced which will then give relief. Laser assisted surgery is also done these days at some hospitals and the results have been good.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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