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CT scan shows hemilaminectomy, disc protrusion. Meaning?

had ct scsan what does this mean? Technique: Contiguous axial sections were obtained through the lumbar spine . Multiplanar reformatted images were obtained. Findings: Mild to moderate loss of disc height is seen the L5-S1 level. Mild loss of disc height is seen at the L4-5 level. Scattered Schmorl node formation is noted. Vertebral body heights are maintained. Grade 1 retrolisthesis of L5 on S1 of 3.3 mm is identified. The T12-L1 level demonstrates no significant bony central stenosis or bony foraminal encroachment. The L1-2 level demonstrates a shallow broad-based disc protrusion with flattening the thecal sac anteriorly. No significant bony central stenosis or bony foraminal encroachment seen. The L2-3 level demonstrates a shallow disc osteophyte complex and superimposed shallow broad-based disc protrusion with mild central stenosis. Mild facet arthropathy and ligamentum flavum hypertrophy are identified. Foraminal encroachment is of mild to moderate degree on the left and mild on the right. The L3-4 level demonstrates a shallow disc osteophyte complex with flattening of the thecal sac anteriorly. Mild to moderate facet arthropathy and ligamentum flavum hypertrophy are seen. Mild central stenosis is present. Mild bilateral foraminal encroachment is noted. The L4-5 level demonstrates disc protrusion lateralizing to the left pre-foraminal location with moderate central stenosis. Foraminal encroachment is of mild degree bilaterally. Hemilaminectomy is noted on the left. The L5-S1 level demonstrates a disc osteophyte complex which appears to abut the S1 nerve root sheaths. Mild bilateral foraminal encroachment is noted. Impression: 1. Hemilaminectomy is identified on the left at the L4-5 level. A disc protrusion lateralizes to the left pre-foraminal location. If needed a contrast study with MR can be obtained to determine whether this is granulation tissue versus a disc protrusion
Asked On : Wed, 9 Jan 2013
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Pathologist and Microbiologist 's  Response
Hello and welcome

The CT report of your lumbar spine gives the following information:

1. There is some abnormality at the level of vertebrae L1 to S1. The vertebrae are numbered according to their location. In lay man language the lumbar region or the lower back is affected.

2. The disc between L1 and L2 shows a disc protrusion. Between two vertebrae, a cartilagenous disc is present. This disc provides friction-less motion between two vertebrae while bendind, turning, and other movements of the spine.

3. At the level of vertebrae L2-L3, an osteophyte is seen. Osteophyte is a bony projection formed due to osteoarthritis (a degenerative condition of bone) of the bone. Between these two vertebrae, there is associated disc protrusion.

4. At L3-L4 level, there is again osteophyte formation.

5. At L4-L5 level, there is disc protrusion.

6. At L5-S1 level there is osteophyte formation.

Protrusion of the disc can further lead to disc prolapse. Disc prolapse can compress the adjacent nerve. This compression can cause weakness, altered sensation, etc in the region supplied by these nerves.

The nerve compressed in this disease process is S1 which supplies the lower limb- the foot region.

A MRI is advised to know whether the structure appearing as disc protrueion is disc or granulation tissue (a tissue formed as a result of inflammation).

Thanks and take care

Dr Shailja P Wahal

Answered: Sat, 26 Jan 2013
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