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Leg weakness,use crane,pain outer hips and thighs,MRI report no evident bulge or herniation,early termination of thecal sac ,epidural fat

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Orthopaedic Surgeon
Practicing since : 1996
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From my MRI report. "L5-S1: Demonstrates early termination of thecal sac with prominence of epidural fat attenuating the thecal sac. No evidence of bulge or herniation identified. Neural foramina are patent.

I take no steroids, an not obese, no Cushings. Should I be concerned? Thanks!! Oh, have leg weakness (walk now with a cane) radicular pain outer hips, front of thighs.
MRI image:
Posted Thu, 3 May 2012 in General Health
Answered by Dr. S S Soni 8 hours later

Thanks for your query
Instead of writing your MRI report,it would have been more useful,if you have mentioned all your symptoms,since MRI is normal
Write about
1. Your age, duration of symptoms
2. Was the leg weakness gradual or sudden ,any muscle wasting & any pain or tenderness? If yes- time & nature of pain
3. Any joint pain
4 Any chronic illness i.e. diabetes, hypertension etc

I would surely answer your once I receive the details

I'll be available for your follow up queries

Above answer was peer-reviewed by
Follow-up: Leg weakness,use crane,pain outer hips and thighs,MRI report no evident bulge or herniation,early termination of thecal sac ,epidural fat 40 minutes later

I am almost 49, female. I was diagnosed with Peripheral Neuropathy over a year ago (moderate in the thighs, severe (Ulnar) in the right arm) via NCS/EMG. At about that time as well, MRI studies showed protrusions at the L23 & L3/4 levels affecting the L2/3 nerve roots - no cord compromise.

ACDF and corpectomy C5/6 - March 08 / ACDF and corpectomy C6/7 August 09 - adjacent level failure. Ulnar (rt. arm) subcutaneously transposition April 08.

No diabetes, borderline high blood pressure (taking 100mg a day of Atenolol), TSH numbers low, but in range, B12, B6, D, C, Folic acid high. High cholesterol on Simvastatin 20mg once a day.

1. Onset was slow - over a 2-3 month period.
2. Muscle wasting on the bottom half (outer) of my thigh.
3. Occasionally thighs are painful to press on.
4. Walking, standing too long, and sometimes sitting, my thighs start to buzz (almost like a cold shiver like rate for the buzz), then escalates to burning and weakness shortly there after. Laying down or sitting in a comfortable chair, it initially burns more, then settles down.
5. Joint pain, no.
6. In a moving vehicle more than 20 minutes my thighs start to spasm and burn many times. Careful standing - stretching, and minor walking calms it down most times.
7. Sitting use to be my "safe spot", but now I have to get up every 20-30 minutes as my back pain rapidly increases, and too transmits to my butt or thighs.
8. Twice in the last week I've almost fallen in the shower as just standing to wash my hair, my leg strength just 'went'. I now have a shower chair 'just in case'.

Initially I would get upper lumbar mechanical pain (constant except for laying down, head and legs elevated). Last August I started having problems walking any distance past around 50 feet. The front of my thighs would burn, buzz and then get extremely fatigued and weak. I would have to stop, bend over and brace myself on my thighs just above my knees. Shortly after that my standing limits started. Presently to say...brush my teeth, I have to do it in 3 stages as the pain almost drops me to my knees with just the minor bend we all do when we brush our teeth!

I started limping as well off of my left leg. No pain in the leg, it just doesn't feel as strong? The foot doesn't 'drop', but points straight or turns in about 15 degrees. Going up stairs has become hazardous in that my right leg doesn't come up enough, and I trip. Have fallen several times getting into my RV!

So, constant mechanical pain in the back - more so to the right. Radicular radiates to the outer hips (bilateral), wraps around the front of my thighs, and down to the top of my calf's. If I lean against a wall, or lean (fairly straight) on my cane, my 3 middle toes go numb - both feet together. Hopefully this helps? Prior to this I was a helicopter and jet pilot and law enforcement officer. I was forced to retire do to this.

A little confused: Early termination of the thecal sac, and epidural fat attenuating the thecal sac is "normal??"

Answered by Dr. S S Soni 7 hours later
Hi again,
There is little bit varition in anatomy of indivisuals & early termination of thecal sac is one of the variation with no adverse effect. & epidural fat is in excess in your spinal canal area, so this is also not doing any harm . So in second thought this is 'NORMAL'.
All your symptoms are mainly 'cos of Peripheral neuropathy. So what you need is Vit.B12 injection & tab. Pregabalin.
I'll also suggest you to get fresh MRI done to rule out any compression,developed lately ,if any,at L2-3 & L3-4 level ,as you have mentioned there was little bit compression in previous MRI.
Take Care
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