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MRI shows central disc protrusion. What does it mean?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
My MRI shows at level L3L4 a small, broadbased central disc protrusion. Moderate neural foraminal narrowing on the right and mild on the left. At L4L5 level, a large central disc protrusion with moderate facet joint and ligamentum flavum hypertrophy on the left and mild on the right. Right neural foramen is markedly narrowed & the left is moderately narrowed. At level L5S1 there is moderate sized central disc protrusion. Moderate facet joint hypertrophy is noted on left and mild on right. Left neural foramen is moderately narrowed & the right, mildly narrowed.
What does all of this mean and what are my options? Am I a candidate for radio frequency?
Posted Tue, 6 Aug 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Hi, thanks for writing to XXXXXXX

All the above mentioned findings in the description suggests degenerative changes and you have MULTIPLE LEVEL DEGENERATIVE DISC DISEASE.

The initial management of your problem will be as follows -

* avoid lifting heavy weights
* avoid forward bending activities
* Use a lumbosacral back support
* Intermittent pelvic traction
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants.

If the above measures fail to produce symptom relief or If the back pain along with leg pain is worsening, then surgical management may be needed.

Radio frequency ablation (RFA) may be useful to provide pain relief in CHRONIC (long lasting) low back pain. A few points of note about RFA -
* The degree of pain relief it provides may vary from person to person
* Pain relief may last from 6 months to 1 year (at times even more)
* Generally a safe and well tolerated procedure
* This is not recommended in patients having active infections or bleeding problems
* As with any other procedure, this is also associated with few complications

Hope I have addressed your issues. Happy to help for any more clarifications.


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