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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Potts Spine, Loss Of Lumbar Lordosis Is Noted, Disc Bulge, Intervertebral Foramina. Done MRI. Meaning?

Respected sir,
I came to know that i was suffering from Potts spine when i did my MRI of the lumbo- Sacral Spine on the date June 17,2013.
The report of MRI test on the date june 17,2013 was:
a. There is a destruction of inferior surfaceof L2 vertebral body and superiror surface of L3 vertrebal body is noted. reduced disc height of L2 vertebral body and L2-L3 disc space. Marrow signal changes noted L2-L3 vertrebal bodies which shows heterogenous low signal intensity in T1 weighted images and heterogenous high signal intensity in T2 and fat suppressed images.Similar marrow signal changes also seen in the pedicle of L2 vertrebal body. Fluid sign is seen in inter vertrebal disc. Slight posterior angulation noted L2-L3 level. Minimal pre and paravertrebal collection is noted. Approax 11.0*4.5*5.0 cm size collection seen in the right psoas muscle which display low signal intensity in T1 weighted images and high signal intensity in T2 weighted images. loss of lumbar lordosis is noted Disc buldge noted at L4-L5 and L5 S1 levels.
b. All lumbar intervertebral foramina are well visualized with exiting nerves roots within superior aspects and do not show any abnormality.
c. Lower part of the cord is normal. CSF space around the cord is sormal. No space occupying lesions seen.
d. no para-spinal abnormilty.
e. No abnormal signal changes noted in dorsal disc, vertrebal bodies and dorsal spinal cord.
f. No abnormal signal changes noted in bilateral hip SI joints.

IMPRESSION.
a. Findings consistent with infective spondylitus and discitis. Minimal paravertrebal abscess. Large right psos abscess. Most likely tubercular pathology.




After the findings of my disese, one of the head surgeon Dr. Basant Pant did my surgery and said that abot 80 ml psos abscess was taken out. Then after i was given the TB drugs followed by vit. B6 supplements.
After that i was doing good and i was able to walk and sit properly even by standing. I was losing my back pain and sometimes residual pain occered. But accidently, one day i feel down on the ground and from that moment i was getting so much pain and weakness in thelegs specially in the right leg. however i was suffering from leg weakness after the operation also but after that accident it was more. So immediatel after the accident I again did my MRI test on the gate August 30,2013and the findings were:

a. Destruction of lower end of L2 and upper end of L3 vertrebal bodies. Reduced disc space with slight posterior angulation noted. marrow signal changes noted at L2, L3 and L4 vertebral bodies and L2-L3 disc which shows heterogenous high signal intensity in T2 and fat suppressed images and heterogenous iso signal intensity in T1weighted images. Similar signal with compromised central spinal canal is seen. Approax. 4.0*3.5*2.5 cm size collection seen in right psos abscess.
b. All lumber intervertebal foramina are well visualized with exiting nerve roots within superior aspect and do not show any abnormality.
c. Lower part of the cord is normal. CSF space around the cord is normal. No space occupying lesions seen.
d. No para-spinal abnormality

IMPRESSION:
a.Findings suggestive of tubercular spondylitis with discitis involving L2, L3 and L4 level vertebral bodies and L2-L3 disc. Compromised central spinal canal at L2-L3 level.
b. Minimal, pre, para and epidural collection with right psos abscess.


Through this report doc said that there was no any defect in the bones and nerves roots due to the accidentand the remaing psos abscess will be eliminated by the TB drugs and after that i was given supportive sticks to walk. Now i m walking with the help of that stick and now i am mainly suffering from my legs. my legs arent getting power but i have lose my back pain while standing and walking. So doctor I have so many question regarding to these diseases but I want to know that when:
My back pain goes out totalyy and will psos abcess will be eliminated by TB drugs?
When i will be cured?
is this curable or not regarding to my condition?
Am I in serious condition?
Mon, 21 Oct 2013
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Neurologist 's  Response
Hi,
Thank you for posting your query.

Your MRI spine reports are favouring a diagnosis of tuberculosis (TB) affecting the spine (lower back bone) and surrounding tissues. In addition, an abscess (collection of pus) was also found in the hip muscle. The diagnosis would have got confirmed after the operation and pus culture and sensitivity.

The abscess has been drained and you are on anti-TB drugs. Generally, treatment is required for at least 18 months and sometimes longer. Most people recover well with treatment.

Regarding the weakness of legs, we need to check whether the leg nerves have also got affected. Please consult a neurologist, who would examine you and may do nerve conduction studies to confirm that.

Physiotherapy should also be done.

I hope it helps.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Apollo Hospitals, Hyderabad
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Potts Spine, Loss Of Lumbar Lordosis Is Noted, Disc Bulge, Intervertebral Foramina. Done MRI. Meaning?

Hi, Thank you for posting your query. Your MRI spine reports are favouring a diagnosis of tuberculosis (TB) affecting the spine (lower back bone) and surrounding tissues. In addition, an abscess (collection of pus) was also found in the hip muscle. The diagnosis would have got confirmed after the operation and pus culture and sensitivity. The abscess has been drained and you are on anti-TB drugs. Generally, treatment is required for at least 18 months and sometimes longer. Most people recover well with treatment. Regarding the weakness of legs, we need to check whether the leg nerves have also got affected. Please consult a neurologist, who would examine you and may do nerve conduction studies to confirm that. Physiotherapy should also be done. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Apollo Hospitals, Hyderabad