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MRI Of Lumbar Spine, Mild Spondylosis, Annular Disc Bulge. Analysis And Treatment ?

Posted on Sat, 29 Sep 2012

Question: Below is my MRI report. What do I conclude of it and what is the cure??
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MRI LUMBAR SPINE

Patient ID: 3296
Patient Name: XXXXXXX XXXXXXX
Study Date : 3-Aug-2011 Age : 26YRS
Sex :MALE
Ref Dr XXXXXXX D.K

Technique: Multiplanar, Multisequence, Multipositional MR Imaging.
REPORT:
Vertebrae:
Lumbar spine shows normal alignment & changes of mild spondylosis.
Bone marrow shows normal signal intensities.
Facetal joints: No significant hypertrophic changes noted.
Spinal canal: Anteroposterior bony spinal canal diameters are within normal range.

Intervertebral discs:
L4-5: Diffuse annular disc bulge with mild impression on thecal sac. No focal root compressions. No extension into the foramina.
Other Discs: No significant disc bulge / herniations.
Cord: Shows normal signal morphology.
Pre and para vertebral soft tissues appear normal.

SI joints:
Articular and periarticular regions are normal.
Joint spaces are normal. No significant joint effusion.

IMPRESSION:
Diffuse annular disc bulge at L4-5 level with mild impression on thecal sac.

Dr. Sharana basappa, MD.
Consultant Radiologist.

Answered by Dr. Atul Wankhede (2 hours later)

Hello,

Thanks for the query.

"Your MRI is necessarily normal, except for the annular disc bulge at L4-5 level."

Fortunately the disc is not causing any pressure over the nerves or cord. Nevertheless it has a chance of doing that soon if you dont take adequate precautions at this stage itself. It can go from bulge to protrusion, from protrusion to extrusion and finally to dessication.

At this stage you have nothing to worry. Do tell us the reason you got an MRI done so that we can help you solve it.

Hope I have answered your query. Should you have any more concerns, I will be available to answer them.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Atul Wankhede (25 hours later)

Thankyou for your reply doctor.

Reason for MRI:
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I was suffering from lower back ache since a moth. I could feel the pain while sitting, even though I sit in the right posture. Forward bending was also painful. While car driving, I would sense shooting pain, mostly on my left leg. I could sense mild pain 24/7 somewhere around SI joints. Especially in the bone inside left buttock. If I sit in a single posture even for 10 minutes, lower back starts getting strained and I get a feeling that it is cramped.

My doctor said MRI was not necessary at that stage but I insisted as I wanted to be sure and get the right treatment.
I also got my SI joints scanned. I would try to attach a copy of that too.

When you say 'precautions'. .. what are those precautions?? Any instruction on sitting and sleeping postures??

If the cause of this pain is not the L4-5 disc, what could be the other causes.

Am a software engineer and have to stick to my work station. If you could guide me the healthy way of doing that.

Also, my travel time to office is 45 minutes one way.

Answered by Dr. Atul Wankhede (10 hours later)

Hello once again.

Thanks for the information.

You are suffering something which we like to call an 'industrial back ache' wherein young IT professionals and engineers face this problem.

I realise you have a nerve problem similar to Sciatica, which can be evaluated clinically.

Your MRI does not suggest a major nerve impingenent. So let us assume that its a mild nerve irritation of unknown origin. We shall now focus on the treatment and prevention from future occurrence.

1. Under your physician's supervision take a course of anti-inflammatory muscle relaxant medicines.
2. Go for physiotherapy in your convenient time for lumbar traction and local ultrasonics.
3. Use local ointments if you wish.
4. Ask your physician about a nerve tonic like Pregabalin 75mg once a day at this stage.
5. Use a lumbosacral brace for a month.

Once the pain completely subsides-
1. Do regular back strengthening exercises that your physiotherapist teaches you.
2. Do not lift any heavy object.
3. No forward bending at all.
4. Use firm mattress to sleep on.
5. Use proper fit clothes and keep back pockets empty.
6. Take frequent stretch breaks at work and dont sit upright all the time if it hurts.
7. Control weight if you are obese.
8. Quit smoking, soft and hard drinks since they are known nerve irritants.

Hope this helps you solve the problem. Feel free to ask more questions.

Wish you a good health.

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Atul Wankhede (12 hours later)

Thankyou Doctor.

Am meeting my physiotherapist tomorrow and would do the needful.

Your response was really helpful.

If you are in Bangalore or Delhi/Noida/Gurgaon, I would want to consult you with my detailed reports.

I want to completely recover from this back ache and it has been a great relief to know that the discs are not the reason for the ache and my condition is recoverable.

XXXXXXX
0000
YYYY@YYYY

Answered by Dr. Atul Wankhede (3 hours later)

Hello again,

Thanks for posting the soft copies of MRI. We appreciate your effort.

A disc pathology is completely ruled out. So go right ahead and have a
physiotherapy session in conjunction with medicines and precautions as
discussed.

I'm glad you are satisfied with our help and at the same time
disappointed that I'm not available at any of the places you
mentioned, but I'm always a click away.

So feel free to discuss any
more details that you need assistance with, and my team will
definitely see you through this ailment.

Wishing you a healthy life. Good bye

Above answer was peer-reviewed by : Dr. Raju A.T