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MRI showed small disc herniations centrally at the L4-L5 level. Surgery needed?

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Neurologist, Surgical
Practicing since : 1997
Answered : 96 Questions
I have an MRI on disk, and want to know if it can be viewed online by a doctor? I also have the short write-up from the imaging center, and want to know if I would be a candidate for surgery. It reads:
L3-L4, Mild disk buldge see. No focal disc herniation.
L4-L5, there is circumferential disk buldge with central disc protrusion. There is arthritic change present involving facets. No canal stenosis.
L5-S1, there is central left paracentral disc protrusion. There is narrowing of the left lateral recess and the origin of the left-sided neural foramen. No canal stenosis. Paraspinal soft tissues are intact.
Impressions: Small disc herniations are seen centrally at the L4-L5 level toward the left at the L5-S1 level.
Posted Mon, 22 Apr 2013 in Brain Tumor
Answered by Dr. Visvanathan K 4 hours later

The scans can be uploaded online or the relevant images copied and sent across to me. However, I dont know how you can get it done!

Briefly, from the report you have uploaded, I can say that at the L3/4 and L4/5 levels there is only disc bulges reported, which means that there is a minimal bulging out of the intervertebral disc material, but it is not compressing the nerves as yet. However, at the lower level, there is a "protrusion" - which is more than a "bulge" and it is causing a narrowing of the space through which the nerve root gets out. Therefore, if the patient has a left sided sciatica and the images confirm what is in the report, surgery certainly is an option. The other options are- continue with painkillers or to try a nerve root block. The choice between the 3 options depends on the patient's symptoms, clinical findings and the MRI findings and finally the patient's preference.

Hope this helps.
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