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MRI of SI joints detected large central protrusion compressing thecal sac, central extrusion compressing nerve roots. Analysis?

Sir, my quarry is, whether my case is operative or not ? sir, here i am quoting my MRI report of SI joints- 1.both SI joints show normal space, with out any evidence of fluid within the joint. 2.there is no evidence of erosion of the subcondral plate. the subcondral marrow is normal & there is no evidence of edema fatty infiltration or sclerosis. 3.the adjacent soft tissues are normal. NOTE IS Made OF: a) large central protrusion (With annular tear) at L4/5 level compressing thecal sac . b) large central extrusion at L5/S1 level compressing bilateral S1 descending nerve roots. IMPRESSION: normal study of SI joints.
Asked On : Fri, 12 Oct 2012
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Orthopaedic Surgeon 's  Response
Hello,

I have studied your case.

Your MRI says large central protrusion (With annular tear) at L4/5 level compressing thecal sac. And large central extrusion at L5/S1 level compressing bilateral S1 descending nerve roots. Exiting nerve root which later on supply lower limb [leg].Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it.

Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.

You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.

I will advise to check your vit B12 and vit D3 level.
MRI shows disc compressing on nerve root then surgical decompression is permanent solution.
As per MRI finding surgery is required, but decision need to be taken after clinical examination, age, patient requirement, and MRI film.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Take care.
Answered: Fri, 1 Aug 2014
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