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What Does My Lumbar Scan Report Indicate?

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Posted on Fri, 20 Mar 2015
Question: I have a few questions in relation to my scans.. first of all I have been on this forum before and I found it very useful I forwarded in july/august time. I am now forwarding you two more scans to look at.
The reading for the Lumbar Scan is as follows:-
Desiccated L4L5 and L5S1 discs with minimal degenerative anterior listhesis of S1 on L5. Satisfactory verbal alignment otherwise. There is a broad based disc bulge and central to right paracentral annular tear at the L4-5 level with a little flattening of the anterior thecal sac and minor right exit foraminal narrowing but no discrete nerve root compression. There is a minimal disc bulge and small central annular tear at the L5S1 level but no appreciable canal or exit foraminal narrowing. Dehydrated disc and small left posterosteral disc bulge and annular tear present at the L3L4 level with minor left exit foraminal narrowing but no discrete nerve root compression. Normal signal throughout the visualised lower cord.
My Cervical Spine reads as follows:- Straightening of the Cervical spine with partial loss of lordosis. Satisfactory verbal alignment otherwise Desiccated disc and advanced degenerative disc space narrowing at C5C6 Level. Dehydrated discs at remaining cervical levels with mild/moderate C6C7 disc space narrowing. There is a moderate sized broad based disc osteophyte with a right sided preponderance at C5 C6 level with moderate to high grade right and somewhat less pronounced left exit foraminal narrowing. There is a similar broad based disc bulge at the C6-C7 level with moderate exit foraminal narrowing bilaterally. Normal signal throughout the cervical and visualised upper thoracic cord. Symtoms in the neck are very sore upper limbs when moving or driving. I have been getting a lot of physiotherapy. My physiotherapy states there are no neurological findings in back or neck..last time I was scanned for neck was last year and got reviews from Healthcare magic. How do I get rid of the trapeziuz muscles pain in upper arm bilaterial.. can you give me your opinion on both these scans.. I have attached both of them. I may send you another copy in a later email of the last back scan taken six months ago and the neck scan taken six months ago. Thanks.. Scan s attached

doctor
Answered by Dr. Dr. Praveen Tayal (2 hours later)
Brief Answer:
Degenerative changes in spine.

Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through your detailed query and investigations carefully. You have degenerative changes in the spine at various levels with minimal nerve root compression. The pain that you have in both the arms is likely to be due to poor posture and lesser muscle tone. This can improve with the help of regular exercises. Bilateral foraminal narrowing at the level of C6-C7 can be taken care of with the help of isometric neck exercises and medicines like Pregabalin and Gabapentin. Using a cervical collar will also help. You can avoid using a pillow.
Do consult a neurophysician and get nerve tonics and muscle relaxants prescribed.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (17 minutes later)
Thank you..i have forwarded you two scans on the both the lumbar and cervical spine..i would appreciate if you could pass a comment on the difference between the two and if you noticed any deterioration. Also C5C6 is impinging on the spinal cord..is this dangerous..or what is your opinion on this..also do you think it is spondoltyitis or arthritis..i had bad compression in the lumbar spine and it all cleared up. Would you be concerned about the degeneration..my biggest worry is the neck..the arm pain is like a needle pain...on certain movements.. I have had a lot of physiotherapy..do you think this should continue..is it spinal stenosis that I am suffering from in the neck..thanks
doctor
Answered by Dr. Dr. Praveen Tayal (10 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
The cervical spine has a greater degree of degeneration but regular exercise can tone up the muscles and revert these changes. You need to increase your fluid intake to avoid disc dehydration.
The mild impingement at C5-C6 is not dangerous but can be responsible for your symptoms. These are spondylottic changes in the spine. You can start taking calcium and vitamin D3 supplements also.
Avoid the painful movements and start taking muscle relaxants orally. It will help in decreasing the stress on the spine and it will gradually improve. The spinal stenosis is only a mild one in your neck.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (8 minutes later)
have you seen much worse than this.. also is the impingement in the neck a bulge or a herniation.. is the c6c7 disc a bad one..i really do not want to end up having surgery so will do all in my power to avoid it.. do you suggest a sit down job..i am not working at the moment..but need to get a job..i have no pins and needles in the hands anymore..physiotherapy reduced this..will the arm pain subside.it is only there on certain movements..is the kyphosis bad and I guess you can not answer the question.. is the spondlotis very bad.thanks so much
doctor
Answered by Dr. Dr. Praveen Tayal (57 minutes later)
Brief Answer:
The disc bulge is a minor one.

Detailed Answer:
The impingement in the neck is due to a mild bulge. I do see many patients with much worse condition in my OPD. You can easily avoid the surgery with the help of exercise and medicines. A sit down job can aggravate the problem. You need to take frequent stretch breaks to avoid any posture related aggravations.
The arm pain will also subside gradually. Your problem is not so bad. This will improve. Please do not worry so much and be relaxed.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (7 hours later)
Thanks..is it a herniation? and also I sent on four scans of different dates.i am wondering did you get them.i would appreciate if you comment on whether there are changes in particular the neck one..thanks very much.would you agree with physiotherapy .. I walk a lot..and how about yoga ..how about the back ..do you see any deterioriation..thanks so much
doctor
Answered by Dr. Dr. Praveen Tayal (1 hour later)
Brief Answer:
In teh scans there is mild herniation.

Detailed Answer:
I got all the scans. The detailed changes can only be appreciated by a radiologist. In the attached reports there is a minor herniation with some impingement on the nerve root.
Physiotherapy and walking will help. In case the pain is severe then cervical traction can be helpful. Yoga will also help.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (2 hours later)
thanks..are you saying that in both the neck scans that there is a mild herniation. ? that is the neck scan taken in February 2014 and in January 2015..my biggest worry is the butting of the spinal cord.. is this very dangerous..i would be seriously concerned about paralysis also do you recommend an epidural..thanks
doctor
Answered by Dr. Dr. Praveen Tayal (3 hours later)
Brief Answer:
Details below.

Detailed Answer:
Yes. The herniation is mild. The nerve root compression at C6-C7 is moderate but not worrisome. The spinal cord compression is not worrisome. It can be decreased with regular exercise.
Paralysis happens with a severe multilevel disc protrusion with foraminal narrowing. Epidural steroids can be considered if the pain is persistent after taking muscle relaxants and physiotherapy
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (24 minutes later)
so you are saying the scans are worse than last year..was there nerve compression on c6c7 last year..am in that boat of servere multilevel disc protrusions,thanks so much for your help.. has the back changed much on scans results..thanks
doctor
Answered by Dr. Dr. Praveen Tayal (8 hours later)
Brief Answer:
Nerve compression was not there last year.

Detailed Answer:
The scans are slightly worse than the last year. But the progression of the problem is not so much so as to cause multi level disc protrusion. In the lumbar region there is no significant change.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (8 hours later)
it is very bad?..what do you mean my multi level disc protrusion? do I have this in the neck....thanks..is the nerve compression bad enough.. would it not be better if they did surgery early to avoid problems later on..thanks. XXXXXXX
doctor
Answered by Dr. Dr. Praveen Tayal (1 hour later)
Brief Answer:
Not very bad.

Detailed Answer:
It is not very bad. Multi level disc protrusion means a significant protrusion of disc at more than 3 levels. You do not have such a severe problem. Nerve compression is only mild. It can improve with treatment. Early surgery will not help the further progression of the problem. It is better to decrease the further progression with the help of exercises and delay the surgery as much as you can.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (2 hours later)
I have just been prescribed with pragabin..I do hope this make help with the arm pain which is only severe on moving hand up or in certain positions..hopefully it will go away..do you think it could need surgery eventually..i really hope that and this is the last resort.i know too many bad stories,,you mentioned isomet. neck exercises.. on there are any on the net..i do have pins and needles..i wonder is physiotherapy making it worse..it felt much worse last year as it was in the neck. my own surgeon is stating that there have been few changes and continue on as I am..is a deciccated disc dangerous.. my biggest worry is nerve damage.. canthis happy the way I am now
is this Neuralforaminal Stenosis .. can you tell from the scans which nerve root is been effected.. c5, c6, c7.. my only problems is the bilaterial problem of the two arms when raising the arms or too much activity.. it does not feel like a neuopatic pain..it is a stiffness..i worry about damaging the nerves..thanks
doctor
Answered by Dr. Dr. Praveen Tayal (2 hours later)
Brief Answer:
Pregabalin will help you.

Detailed Answer:
Pregabalin will help in decreasing the pain. This will go away with regular physiotherapy.
Surgery can be avoided for next 5-7 years.
Do not be in a hurry to go for surgical treatment. It will not stop the disease progression.
Nerve damage will not happen if you do regular exercises and go for yearly MRI scan to see the progress.
Only C6-C7 nerve root is affected. The stiffness is related to muscle pain. Doing a hot compress in the area and taking oral muscle relaxants will help.
Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Praveen Tayal (40 minutes later)
is it at the bad stage of progression..and is surgery really a necessity.i like to plan for the future..in your experience with patients as alert as me in relation to progression..what are you thoughts and can I ask is this arthritis of the neck.i forwarded you my blood results..is it fibriolga? thanks so much.
you are very helpful with all these answers.. I would appreciate if you let me know if it is ok to swim..i love swimming.. will this aggravate the problem.the arm pain is a stiffiness.i am also attaching my physio report to read as it describes my symtoms from a clinical point of view. She is excellent..i do lots of walking lately about four miles a day and I also make sure to stretch my arms..will this cause damage..thanks.. also is there any nerve root coming from c5c6. see attached report..it may help you understand the issue of the needle arm pain.. by the way I have found your advise excellent
doctor
Answered by Dr. Dr. Praveen Tayal (8 hours later)
Brief Answer:
Not due to fibromyalgia.

Detailed Answer:
The rate of progression is slow and is not bad. You may not need any surgery for years. You can continue with the regular exercises. It is not due to fibromyalgia.
Swimming is a good exercise for you. If you have a full range of movement in the arm then you can do swimming. It will help in relieving the stiffness.
Walking and stretching will not cause any damage.
There is disc protrusion at C5-C6 also causing a foraminal narrowing and nerve root compression. This should decrease with pregabalin. Adding methylcobalamin supplements will also help.
Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Praveen Tayal (47 minutes later)
thank you..i would really appreciate if you could let me know if you read my physical therapy's report..as I go regularly. Do you think massage and mobilisations are safe. I have full range of movement just stiffness. Have you seen people with this condition never having surgery..is it normal for my age to be having this condition. I am not working at the moment and wonder if I will ever be able to work again as it is very unpredictable from day to day..also could you tell me is there a disc protrusion in the lumbar spine.. l4l5. I guess at this stage we can understand that this arm pain is related to the nerve compression. thanks for all your help.you are really helping me..neck surgery is the last resort and I am attending the best surgeon in the country of XXXXXXX He will not go near surgery unless it is absolutely crucial. thanks
doctor
Answered by Dr. Dr. Praveen Tayal (42 minutes later)
Brief Answer:
Massage and mobilizations are safe.

Detailed Answer:
Yes. I have read the physical therapist's report. The massage and mobilizations are safe. It is normal for your age and i do see many such patients in my OPD regularly who manage with regular exercise and never need a surgery.
You will be able to work in few months. There is a disc protrusion with a small annular tear at L4-L5.
You are under a good guidance. Do follow your doctor's instructions carefully.
Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Praveen Tayal (30 minutes later)
Is disc protrusion in back ecting the spinal canal at all..and is the l3l4 roububles ton. .thanls
doctor
Answered by Dr. Dr. Praveen Tayal (30 minutes later)
Brief Answer:
No nerve compression.

Detailed Answer:
The disc protrusion in the back is not compressing the nerve roots. There is disc dehydration. Increasing the fluid intake will help.
Regards.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr. Praveen Tayal (33 hours later)
Thanks very much for your help. I went swimming two days ago and there was a lot of impingement on thoe right arm the next day. Is it really safe to be swimming with nerve root compression. Thanks so much for all your advice.
You have been very good
doctor
Answered by Dr. Dr. Praveen Tayal (57 minutes later)
Brief Answer:
Swimming is safe.

Detailed Answer:
Swimming is safe as long as the pain is not severe so as to cause a further restriction of the activities. It is better to go slow. Take the help of muscle relaxants and start gradually.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12310 Questions

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What Does My Lumbar Scan Report Indicate?

Brief Answer: Degenerative changes in spine. Detailed Answer: Hello, Thanks for posting your query. I have gone through your detailed query and investigations carefully. You have degenerative changes in the spine at various levels with minimal nerve root compression. The pain that you have in both the arms is likely to be due to poor posture and lesser muscle tone. This can improve with the help of regular exercises. Bilateral foraminal narrowing at the level of C6-C7 can be taken care of with the help of isometric neck exercises and medicines like Pregabalin and Gabapentin. Using a cervical collar will also help. You can avoid using a pillow. Do consult a neurophysician and get nerve tonics and muscle relaxants prescribed. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal