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Lumbar MRI done for persistent low back pain. What does the report suggest? What is the problem?

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Spine Surgeon
Practicing since : 2002
Answered : 322 Questions
I had a Lumbar MRI for persistent low back pain-
There is focal disc disiccation and loss of disc space height at L3 - S1. The marrow signal is unremarkable. The cord ends at L1. There is a dorsal sacral Tarlov cyst. L3-4 has a subtle asymmetric disc bulge to the right closely apposed to the Right L3 nerve root far laterally & L4-5 is the same. L5-S1 there is a mild broad based disc bulge with subtle component of left paracentral disc protrusion the disc material is traversing left S1 nerve root.
Posted Wed, 21 Nov 2012 in Osteoporosis
Answered by Dr. Rahul D Chaudhari 5 hours later
Thanks for writing to us
In spine the correlation between clinical symptoms and MRI findings is very important. Your MRI indicates age related changes in spine (may be little faster in your case). Back pain is usually from the bad discs and leg pain is due to nerve compression. I think you only have back pain and no leg problem. Please correct me if I am wrong. Also Tarlov cyst is usually asymptomatic and if it is symptomatic then it causes leg tingling and bowel, bladder dysfunctions. Thus in your case, bad discs are the culprit which are giving you this back pain.
Initially we always try to treat it conservatively with medicine an physiotherapy. However if it failed and you still have persistent pain which is hampering your day to day work, then we may have to consider surgical option. In that case we may need to establish the painful disc by doing discography. Once the painful disc established then it can be treated with removing the disc and fusing the spine (or sometimes disc replacement).
I hope I answered all your queries.
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Follow-up: Lumbar MRI done for persistent low back pain. What does the report suggest? What is the problem? 14 hours later
My pain is along my hips, groin, tailbone & I have numbness and tingling legs & feet. More pronounced on the left side. There are times that the pain is so bad that I can't stand. The majority of the time I can neither sit or stand for long, 15 minutes maximum. I had a bad epidural 28 years ago and I have had persistent back & sciatica pain since. It became an issue that I couldn't work through 33 months ago, after a fall. I have had the tarlov cyst for four or more years, often it is tender. I have suffered from constipation for some time. It is approximately a cm in size. I have had PT twice, I have been on a medicine 'cocktail' for 20 months that gives me minimal relief, I have had 5 sets of shots and I saw a surgeon 2 years ago that mentioned the exact surgery you did, but told me to wait due to my age. Please explain the options.
Answered by Dr. Rahul D Chaudhari 7 hours later
Thanks for the information.

It seems you have significant disability due to back problem. You have both back and leg problem. I think you are a surgical candidate now and need decompression with fusion. Definitely you are younger to carry out long spinal fusion.

I need to see your MRI to tell you more details of the surgery. If possible please upload your MRI report and images. You have a feature to upload the reports/images on the right side of this query page. You may utilize it, so that I can suggest you better.

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