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Severe back pain, urine incontinence, MRI suggests no stenosis, effacement of the right lateral recess, distended bladder. Suggestions?

im having very bad back pain here is my mricould you tell me what is wrong. im 30yr male Exam Desc: MR LUMBAR SPINE WITHOUT CONTRAST (MRLSPWO) Exam Date: 06/15/2012 Exam Time: 06:00pm Reason for Exam: BACK PAIN URINE INCONTIENCE SECONDARY TO TRAUMA EXAM: MR LUMBAR SPINE WITHOUT CONTRAST CLINICAL HISTORY: BACK PAIN URINE INCONTIENCE COMPARISON: None. TECHNIQUE: FINDINGS: The bladder is greatly distended, measures over 12 cm in diameter and not fully assessed on today s study. The plain films do show 5 lumbar type vertebral bodies. There is loss of height and signal at L3-S1 disc levels. The conus signal is normal at the L1 level. At the L5-S1 disc space mild vertebral endplate degenerative change minimal disc bulge but the AP diameter of canal is still normal at 2 cm. No significant foraminal narrowing. At L4-L5 disc space moderate degenerative change and disc bulge effacing the central thecal sac , but AP diameter of canal still about 19 mm within normal limits. Bulge is predominantly central there could be a small superimposed central protrusion but no significant stenosis. At L3-L4 disc space there is moderate degenerative change with a disc bulge with a superimposed right HNP effacing the right paracentral thecal sac and causing moderate effacement of the right lateral recess. This right-sided disc measures 5 mm in AP diameter superimposed on bulge and is best seen on sagittal image 7 axial image 19. The residual AP diameter of the canal in the midline is 17 mm. No foraminal narrowing. At the more proximal lumbar disc spaces essentially negative. IMPRESSION: Degenerative changes are moderate at L3-4 through L5-S1 with loss of disc height and signal, moderate for patient s age. Disc bulges at L4-L5 and L5-S1, a central bulge at L4-L5 but no spinal stenosis . At L3-L4 a bulge and a superimposed moderate right HNP effacing the central and right thecal sac and causing moderate effacement of the right lateral recess . Distended bladder. Authenticated By: , Approval Date/Time: 06/16/2012 12:55PM THIS REPORT WAS RECEIVED FROM AN EXTERNAL RIS SYSTEM
Asked On : Fri, 27 Jul 2012
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Anesthesiologist 's  Response
Probably you have traumatic lumbar disc bulge esp at L4L5 and due to which you have sevrre back ache and features of urinary retrnsion.
If the pain severe associated witj bladder symptoms you may need urgent surgery.
Kindly consult a neurosurgeon. In the meanwhile take absoute bed rest. LUMBO SACRAL CORESET need you need wear. Take pain killer and pregabalins.
Answered: Tue, 3 Dec 2013
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