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What does my scan report indicate?

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Posted on Wed, 25 Nov 2015
Question: I would very much appreciate if you could review this scan please..thanks..i have cramping and weakness in my legs.thanks
doctor
Answered by Dr. Ajay Panwar (39 minutes later)
Brief Answer:
L3-L4,L4-L5,L5-S1 disc bulges with possible radicular compression.

Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your MRI of spine.
It shows Degenerative changes in spine with diffuse osteophytes.
There are significant disc bulges at L3-L4,L4-L5 and L5-S1 levels.More prominent at L4-L5 and L5-S1 levels.
Disc bulges at L4-L5 and L5-S1 appear to be causing narrowing of exiting nerve foramina.Possible nerve radicular compression.

Your symptoms are probably due to resulting L-S radiculopathy at the L4-L5 and L5-S1 levels.

If you describe your symptoms in detail,that may help a better clinical correlation-Do you have any problem in gripping footwear?Do you have a problem in standing from squatting position?Do you have the history of knee buckling?

If you have further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar (25 minutes later)
thanks..
symtoms are exacberated by standing and walking and pain in front of thigh and back of thighs..middle f groin ..surgeon says it is lateral recess stenosis and has made a suggestion of doing a laminotmy ..risks are there are annual tears..but he feels confident that this could work...was at my physiotherapy who has noticed weakness in the legs..i do not have a problem in gripping footwear just painin both legs.. I am doing my best to build up my muscle.. I am so afraid that I could wasting of the muscle..also could you give me your opinion on such a surgery..is this dangerous and is it successful.. also I would appreciate if you could look at my neck scan and give me your opinion
doctor
Answered by Dr. Ajay Panwar (1 hour later)
Brief Answer:
Surgery should be done if the symptoms are not responding conservatively.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

At this point,I must make a statement that 'Surgery in this scenario is to be done only if symptoms are not responding optimally to medicines and physiotherapy'.In other words,if your symptoms are not getting controlled and are restricting your functional and occupational capabilities,only then you should go for surgery.

Surgery is to be weighed in terms of risks vs benefits.If it is expected that outcome after the surgery will be better as compared to the pre-surgery condition,only then surgery should be done.

Lets take a scenario,where a patient is having mild persistent pain but is able to do his routine works normally and he thinks that he should get surgery done so that his pain gets eradicated.Now in such a situation,he may even start having more pain after surgery or condition may remain as such.
So,till the time an individual feel that he can do without surgery,he should not go for it.

Sure,you can upload your MRI neck and I shall have a look at it.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar (8 hours later)
thanks.. what is lateral rescess stenosis
can this condition cause wasting of the legs
also I have been trying to upload my scans..upper back.. perhaps you may be alble to do this.. as I have sent my neck scan as of the last month. could you search for me I am having great difficulty..many thanks
doctor
Answered by Dr. Ajay Panwar (12 hours later)
Brief Answer:
Please clarify the scans status?

Detailed Answer:
Dear XXXXXXX
Thanks for being in follow-up.

Lateral recesses are small openings between the vertebrae of the spine through which nerve roots emerge from the spine.Of course,Lateral recess stenosis(stenosis means narrowing) will reduce the space available for exiting nerve radicles and they will get compressed. Compressed nerve radicles will impair the nerve supply of muscles of legs,thus causing wasting.

I could not understand what do you want to say about the scans.Are they already uploaded on the website.If yes,please provide the link of the question to which scan you are referring to.Its better if you can upload that particular scan here,which you want me to see.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar (6 hours later)
I am sorry but I am having a problem with uploading the scans..i would very much appreciate if you could see could you find them on this site..i have uploaded the neck scans before

Do you see lateral recess stenosis on my scans..in the back thanks
doctor
Answered by Dr. Ajay Panwar (43 minutes later)
Brief Answer:
Lateral recess stenosis is evident.

Detailed Answer:
Dear XXXXXXX
Thanks for being in follow-up.

I did find out and went through your MRI of cervical spine. Findings are exactly matching as mentioned by you in the medical history.

Diffuse osteophytes are seen.
Disc protrusions at C5-C6 and C6-C7.More prominent at C5-C6 with significant thecal compression.It is impinging on the surface of spinal cord.Also appears to narrow the nerve root exiting foramina.
Overall,it is a DEGENERATIVE SPINE DISEASE.

Further,Yes;Lateral recess stenosis was evident in your lumbosacral spine scan.

Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Please get back to me in case you have any query in future.
You can also put up a query directly to me on HCM address- http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69273

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ajay Panwar (1 hour later)
Thanks very much for this...
You are very helpful. My surgeon has recommended that I have surgery.. he is recommending a laminotmy.. this is for the spine.. is there lateral recess stenosis all over the lumbar spine.
What are your recommendations on the neck..
symptoms...upper nerve pain on both arms (upper)
Thanks very much
doctor
Answered by Dr. Ajay Panwar (12 hours later)
Brief Answer:
L4-L5 and L5-S1

Detailed Answer:
Dear XXXXXXX
Thanks for being in follow-up.

No,lateral recess stenosis is not present all over the lumbar spine.It is mainly at L4-L5 and L5-S1 levels.

In neck,C5-C6( to lesser extent at C6-C7)foraminal narrowing is probably causing nerve radicles compression,which is causing your symptoms.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Ajay Panwar (36 hours later)
thank you ..I find you very helpful..
what surgery would you recommend for the L4L5
also.with the neck...have you any suggestions in relation to the nerve radicles compression..do you think this could settle or would it need a surgery..
doctor
Answered by Dr. Ajay Panwar (15 hours later)
Brief Answer:
Surgery,only if symptoms are not controlled with medicines and physio.

Detailed Answer:
Dear XXXXXXX
Thanks for being in follow-up.

Surgery for neck symptoms should be considered only if symptoms are not controlled even on medicines and regular physiotherapy.On similar principles,as I mentioned for lumbo-sacral spine surgery.

L4-L5 pathology probably will need laminotomy.However,neurosurgeon's opinion should be taken on deciding the choice of surgery.

I shall be glad to answer your further questions.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ajay Panwar

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What does my scan report indicate?

Brief Answer: L3-L4,L4-L5,L5-S1 disc bulges with possible radicular compression. Detailed Answer: Hi XXXXXXX Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. I have gone through your MRI of spine. It shows Degenerative changes in spine with diffuse osteophytes. There are significant disc bulges at L3-L4,L4-L5 and L5-S1 levels.More prominent at L4-L5 and L5-S1 levels. Disc bulges at L4-L5 and L5-S1 appear to be causing narrowing of exiting nerve foramina.Possible nerve radicular compression. Your symptoms are probably due to resulting L-S radiculopathy at the L4-L5 and L5-S1 levels. If you describe your symptoms in detail,that may help a better clinical correlation-Do you have any problem in gripping footwear?Do you have a problem in standing from squatting position?Do you have the history of knee buckling? If you have further questions,I shall be glad to have you in follow-up. Regards Dr.Ajay Panwar, MD,DM(Neurology)