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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What are the findings of the MRI report?

THE LUMBAR SPINE : Dear Doctor my son age 21 years, ht 5 11 good health, till 3/4 days ago was regularly doing gym but for the last one year had a pain in left thie and MRI report says : There is straightening of lumbar curve. The lumbar vertebrae are normal in height, alignment and marrow signal characteristics. A small focus appearing hypointense on T1 as well as T2W images is seen in the S1 vertebra on right side - likely bone island. Small early schmorl s nodes are seen at D10-11 to D12-L1 levels. Rest of the lumbar discs are normal. No significant disc herniation is seen at any other level. No evidence of developmental bony spinal canal stenosis is seen on this study. Pre & paravertebral soft tissues are unremarkable. The visualized cord is normal in signal intensity and morphology.Conus is normal in position and signal intensity. STIR coronal sections of the sacroiliac joints do not show abnormality. IMPRESSION : Posterior disc bulge with annular tear and large postero-central- left subarticular disc extrusion at L5-S1 level causes thecal sac indentation and left lateral canal narrowing with compression of left traversing S1 nerve root.
Tue, 18 Feb 2014
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Radiologist 's  Response
Hello
Thanks for writing to us

According to MRI report your son has degenerative disc disease of lumbar spine.
Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis which allows herniation of disc.

1.At L5-S1 level there is posterior disc bulge with annular tear and large herniation of disc in left postero-central region.It is causing indentation of thecal sac and left neural foramen narrowing with compression of left exiting S1 nerve root.

There is also straightening of lumbar curve most probably due to spasm.

There is small early schmorl's nodes are noted at D10-11 to D12-L1 levels

Treatment for degenerative lumbar disease includes physiotherapy or surgery.
Effectiveness of both modalities are same.So,physiotherpay should be tried first. It causes strengthening of Para spinal muscles and it prevents further changes.
Surgery should be the last option.
There are also medicines like capsule pregabalin available for pain relief.
Other pain relieving modalities are Ozone ablation,Radiofrequency ablation,percutaneous disectomy etc.
Steroids are also used for foramen block,but it is not the definite treatment.

Treatment can be planned after consultation with neurosurgeon.

Get well soon.
Take Care
Dr.Indu Bhushan
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