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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is extreme lower back and abdominal pain when there is mild indentation in the thecal sac a cause for concern?

Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6541 Questions

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Posted on Tue, 11 Dec 2018 in X-ray, Lab tests and Scans
Question: Hi,

I am having extreme lower back pain going into my abdominal. I received an mri of my lumbar spine and the radiologist noted a mass effect but didn't state what was causing this. On an MRI I had a year ago in the same area this was not noted. Can you explain my report and what he is speaking of causing the mass effect? Should I be worried it wasn't on the last scan? This is the report :L5 S1 mild broad based disc bulge with slight super imposed right foraminal disc protrusion. Small annular tear in the right foraminal region as well. Mild mass effect on the anterior thecal sac with partial effacement of the right lateral recess but not significant central canal narrowing. Mild right and no significant left neural foraminal narrowing.
doctor
Answered by Dr. Vivek Chail 54 minutes later
Brief Answer:
It is not a serious problem and describes mild indentation on the thecal sac.

Detailed Answer:

Hi,

The words mass effect are used in your report to describe the slight indentation on the covering of the spinal cord due to a posterior disc bulge. It has been clearly mentioned that the mass effect is mild and on the anterior thecal sac area and not causing central canal narrowing.

The rest of the report describes the mild pressure on the right nerve root in the L5-S1 disc level.

As such there is no serious finding in your report.

Hope I have answered your query.

Regards,
Dr. Vivek Chail
Radiologist
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Vivek Chail 2 hours later
Hi,

Thank you for your response. I guess I was confused as he didn't state specifically that the disc bulge was causing the mass effect. Is it possible this was just missed on the first one as the first MRI showed everything he mentioned including the disc bulge minus the mass effect? If something pathological was the cause it would show correct?

Thank you again.
doctor
Answered by Dr. Vivek Chail 4 hours later
Brief Answer:
There is no other pathology causing mass effect, if not specified

Detailed Answer:

Hi,

There is a possibility that there might be a mild increase in the disc bulge in the new scan and therefore it was highlighted as causing a mass effect.

Another possibility is that there can be slight variations in findings reported by different radiologists and it is possible the mass effect existed in the previous scan and was ignored in the previous report because it is mild.

There is no other pathology like a tumor or infection, if your doctors have not mentioned in the report.

Hope I have answered your query.

Regards,
Dr. Vivek Chail
Radiologist
Above answer was peer-reviewed by : Dr. Nagamani Ng
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