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What Does "diffuse Bulge Of L4-5 Disc Indenting The Thecal Sac" Mean?

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Posted on Mon, 12 May 2014
Question: i am 28 my mri result shows diffuse bulge of l4-5 disc indenting the thecal sac and enroaching the neural foramina, no significant nerve roots compression ,mild bulge of l5-s1 disc indenting the thecal sac ,no significant nerve root compression ,, ligamentum flavum thickening at l4-5 level ,and the lumbar canal diameters at disc level are as follow ,,, l1-2 18.0mm,,,,l2-3 18.0mm,,,, l3-4 16.0mm l4-5 11.0mm,,,l5-s1 8.4 mm
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Answered by Dr. Indu Kumar (37 minutes later)
Brief Answer: Physiotherapy is ideal in your case. Detailed Answer: Hello XXXX Thanks for writing to us According to MRI report you have 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. These changes are early in your case. 1.At L5-S1 level there is mild disc bulge which is indenting the thecal sac.There is no significant nerve root compression. 2.At L4-5 level there is diffuse disc bulge indenting the thecal sac and it is encroaching the lateral neural foramen.There is no significant nerve root compression. 3.There is ligamentum flavum thickening noted at L4-5 level. 4.Mentioned lumbar canal diameters are normal. 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. There are also medicines like capsule pregabalin available for pain relief. Treatment can be planned after consultation with neurosurgeon. You should avoid lifting heavy objects. I think you will be get relief from physiotherapy. There is no surgical intervention at present. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indu Kumar (15 minutes later)
Sir but from last about more then a month i am going for physiotherapy but my pain is not going to normal before it was paining regular but now when i bend down i feel pain otherwise not
doctor
Answered by Dr. Indu Kumar (2 hours later)
Brief Answer: Please find detail answer below. Detailed Answer: Hello XXXX Thanks for writing back Earlier you had regular pain but now pain is when you bend down otherwise not,it shows improvement. Ideally physiotherapy should be avoided in painful condition.It must be started when pain subsides. There are many pain relieving modalities like deep ultrasound therapy,TENS(Trans cutaneous electric nerve stimulation),Foramen nerve block by anaesthetic and steroid injection,epidural injection etc.You can go for any one method after evaluation. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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What Does "diffuse Bulge Of L4-5 Disc Indenting The Thecal Sac" Mean?

Brief Answer: Physiotherapy is ideal in your case. Detailed Answer: Hello XXXX Thanks for writing to us According to MRI report you have 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. These changes are early in your case. 1.At L5-S1 level there is mild disc bulge which is indenting the thecal sac.There is no significant nerve root compression. 2.At L4-5 level there is diffuse disc bulge indenting the thecal sac and it is encroaching the lateral neural foramen.There is no significant nerve root compression. 3.There is ligamentum flavum thickening noted at L4-5 level. 4.Mentioned lumbar canal diameters are normal. 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. There are also medicines like capsule pregabalin available for pain relief. Treatment can be planned after consultation with neurosurgeon. You should avoid lifting heavy objects. I think you will be get relief from physiotherapy. There is no surgical intervention at present. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX