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What Does My MRI Report Indicate?

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Posted on Tue, 7 Oct 2014
Question: lumbar vertebral alignment is normal. There is significant degeneration at the lower two lumbar levels. (L4L5). The lumber vertebral heights are all normal. The lower cord is normal. At L4L5 there is slight loss of height of the disc and reduction in disc signal.. there is substantial right parcentral and posterolateral disc extrusion adjacent to a posterior annular tear and there is compression on the descending right fifth lumbar nerve root. The central spinal canal dimensions are reduced at this level as a consequence. At L5S1 there is a central and left paracentral posterior annular tear and a shallow central and paracentral disc bulge but no evidence of nerve root compression. Clinical correlation advised.
doctor
Answered by Dr. Suresh Heijebu (1 hour later)
Brief Answer:
Lumbar spondylosis-mild

Detailed Answer:
Hi,

These changes on your MRI scan reflect LUMBAR SPONDYLOSIS WITH MILD SPINAL CANAL STENOSIS.

This is a degenerative disease of the cartilagenous discs in between two vertebral bodies.

This degeneration in your case has affected the discs between 4th and 5th lumbar vertebrae, 5th and 1st Sacral vertebrae.

This degeneration of the disc has caused backward displacement of itself onto the spinal cord,right 5th nerve root and ligamentous structures behind supporting the back muscles.

These changes are very mild to absent at the L5-S1 level.

Hence you currently are not experiencing any symptoms since the changes are not intense and you are currently placed on nerve stabilizing measures with diazepam and amitriptiline.

In case if you have any symptoms like buttock pain and bowel and bladder difficulty,refer to your treating doctor immediately.

I hope this info is helpful to you,
Thank you

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Suresh Heijebu (6 days later)
Thank you for your prompt reply. I went to my Surgeon who has suggested surgery although my neurological symtoms are not severe.. pins and needles. I have noticed recently that i am getting pins and needles on my left foot. My surgeon was going to operate on the L4L5 right nerve root. He has suggested a microdiscemony. I also have an issue with my neck... there is mild angular kyphosis centred centred at C5C6 where there is disc narrowing, disc dehydration and osteophytosis. Axial scans show right paracentral disc protrusion which impinges on the surface of the cord. There is bony encroachment on the exit foramina bilaterally. No other finding. I had severe problems with walking on my right leg up to recently.. however my neck acted up again.. do you think surgery would help my situation. Why have I pins and needles on the left leg. Thanks

the question i am asking you is .. do you think i would benefit from surgery.. i had ten weeks of leg pain only upon walking on my right leg.. it seems to be settling but there is a good bit pressure now in my lower back and up the spine.. my surgeon would like to operate soon..is this necessary..he is excellent and does not conduct such surgery easily
doctor
Answered by Dr. Suresh Heijebu (9 hours later)
Brief Answer:
Surgey is an immediate and definite requirement.

Detailed Answer:
Hi, Madam,

I have carefully read your query and understand your concern.

let me clarify to you once for all,that you would now certainly benefit from the surgery-Microdisectomy with/with out laminectomy Of L4/L5 nerve root for the left leg symptoms.

10 week leg pain brought on walking is referred to as Intermittent Neurogenic Claudication.

This along with sensation of pins and needles(paresthesias) is a indication of significant cord compression and indication of early and a definite surgical intervention.

So i request you not be hesitant with your Surgeon's decision.
Please go ahead with the surgery.

I would also like stress similar importance to the neck MRI changes you currently have.

These disc protrusions at C5/C6 are likely to progress and advice you to keep a watchful eye for the development of similar symptoms.

This neck region may also require similar surgery in the due course of time.
So i request you to keep in touch with your surgeon.

I hope this info is helpful to you,
Thank you

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Suresh Heijebu (3 days later)
Thanks..my surgeon decided to postpone surgery as my pins and needles symtoms were improving,..was wondering if it was possible for you to explain why i get pins and needles on the left foot given the fact it is a right sided protrusion..i have no weakness..also do you think it is necessary to see a neurosurgeon for this condition?
thanks
doctor
Answered by Dr. Suresh Heijebu (3 hours later)
Brief Answer:
Neurosurgeon consultation is needed

Detailed Answer:
Hi,

Its good to hear that your surgeon decided to postpone your surgery as your symptoms are improving.

The motor and sensory nerve tracts originating from the brain decussate(cris cross) at the lower part of brain stem before they travel down the spinal cord ie right sided nerve tracts travel down the left side of the spinal cord and vice versa.

Hence the symptoms vary laterally inverted.

Its also very important to see a neurosurgeon in your follow up visits.

Thank you
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Suresh Heijebu (1 hour later)
I am actually seeing a spine surgeon. He did a brain scan and there was no underlying pathology. I asked him about seeing a neurosurgeon before but he said that this was not an issue. He is relatively young.. why do you think I would benefit from seeing a neurosurgeon?
doctor
Answered by Dr. Suresh Heijebu (2 hours later)
Brief Answer:
You require expert care above an ordinary care

Detailed Answer:
Hi Madam,

welcome back

A neurosurgeon is an expert doctor who gets exclusively gets trained in operating the brain and spine pathologies.

He is also at expert in surgical management of spinal decompression secondary to various diseases of intervertebral disc.

He is treats and operates both brain and spinal neural tissues with equal degree of sensitivity and accuracy.

no other doctor in medical fraternity can handle the surgical spinal pathologies with this degree of accuracy.

Its not the point of being young or old ,but its the point of having the qualification of MCH-Neurosurgery or not.

Also in future if at all you are going to get your spine operated,i strongly signify this to be done in the hands of a Neurosurgeon and none other.

Hence i strongly recommend you have a follow up of this specialist doctor.

Thank you,.
Take care
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Suresh Heijebu (6 minutes later)
Are you saying that I need bigger surgery that a microdisectomy?
doctor
Answered by Dr. Suresh Heijebu (59 minutes later)
Brief Answer:
surgeons choice is crucial

Detailed Answer:
Hi Madam,

As per your symptoms a minor microscopic procedure like Discectomy or a more specific approach like Laminectomy is preferred.

It depends on your surgeon's choice.

In my opinion a laminectomy is more preferable.

Thank you
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Suresh Heijebu (2 hours later)
you have my details. i have forwarded you my scans already
doctor
Answered by Dr. Suresh Heijebu (12 hours later)
Brief Answer:
Laminectomy is procedure of choice

Detailed Answer:
Hi Madam

i have gone through your uploaded scans.

There is significant cord compression at L4/L5 level.

Laminectomy is preferable in my opinion to prevent recurrences.

Thank you
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Suresh Heijebu (17 minutes later)
do you mean spinal cord compression .. or lumbar cord compression...did you review my cervical scan
doctor
Answered by Dr. Suresh Heijebu (52 minutes later)
Brief Answer:
Compression at both levels.

Detailed Answer:
Hi Mam,

Yes, I have reviewed your spinal cord.

You have spinal cord compression in both lumbar and cervical regions .Thats what i mean

The severity of lumbar cord compression is more than cervical cord compression.

You need to have follow up scans of both cervical and lumbar regions,that is an MRI total spine will be more accurate.

Thank you

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Suresh Heijebu (25 minutes later)
is it possible to get an mri of the total spine..my consultant told me that he was not concerned about the neck region...is it very significant at the spinal cord area.. the neck..is this very dangerous.. what are the diameters like at the spinal canal area

I have already got a lumbar scan recently..the cervical scan was only done in February along with the brain scan..at my preassessment they did a lumbar spine check xray.. does show up anything?

would a microdisectomy help with the compression...in the spinal cord.. this is what the consultant was going to do.. he is a spine surgeon and is meant to be the best in the country..

can you get an total mri of the spine?
doctor
Answered by Dr. Suresh Heijebu (6 hours later)
Brief Answer:
Total MRI spine is widely available scan.

Detailed Answer:
Hi Mam,

Yes ,neck is indeed the most important region of the entire spinal cord only because all the important nerve tracts supplying all the four limbs along with nerve innervation to bowel and bladder.

Hence this area has to be given the special care.

You need to monitor the degenerative disc changes over the course of time to detect any large disc herniations carrying the risk of large area spinal compression.

You had your last scan in feb,its will better if you can have it again now.

Yes total MRI spines are very frequently done spine investigation,quite widely available.

Yes microdiscectomy is very good option ,involves removing the injured disc microscopically.

Its cosmetically more acceptable and conservative.

The success rates are often high in the range of 90-95%.

Certainly microdisectomy help to relieve the herniated compression.

Thank you
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

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

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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What Does My MRI Report Indicate?

Brief Answer: Lumbar spondylosis-mild Detailed Answer: Hi, These changes on your MRI scan reflect LUMBAR SPONDYLOSIS WITH MILD SPINAL CANAL STENOSIS. This is a degenerative disease of the cartilagenous discs in between two vertebral bodies. This degeneration in your case has affected the discs between 4th and 5th lumbar vertebrae, 5th and 1st Sacral vertebrae. This degeneration of the disc has caused backward displacement of itself onto the spinal cord,right 5th nerve root and ligamentous structures behind supporting the back muscles. These changes are very mild to absent at the L5-S1 level. Hence you currently are not experiencing any symptoms since the changes are not intense and you are currently placed on nerve stabilizing measures with diazepam and amitriptiline. In case if you have any symptoms like buttock pain and bowel and bladder difficulty,refer to your treating doctor immediately. I hope this info is helpful to you, Thank you