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What Does The Following MRI Report Indicate?
Question: I had an MRI and found a slight bulge at L4/5 and have had pain for 7 weeks now. I am about 80% but appear to have stayed the same so I am considering an injection. I have had acupuncture, massage, and been taking 600mg of Advil since the pain first started. I am an active 67 year old and getting frustrated.
Brief Answer:
Take treatment as advised and upload reports
Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
You seem to be suffering from lumbosacral radiculopathy due to compression of nerve root secondary to disc prolapse.
You need to be treated under a neurologist.
You should avoid stooping forward, lifting heavy objects, squatting, sitting crossed leg.
Regular back exercises under physiotherapist guidance.
Pain killers with muscle relaxant like etoricoxib or Aceclofenac with thiocholchicoside or tizanidine can be taken instead of advil.
Pain modulator drugs like pregabalin or amitryptiline or gabapentin can be used.
Injection for pain relief as steroid or anesthetic agents are also option.
In case of non responsive pain, Surgical procedure can be considered after consulting a neurosurgeon.
Hope you found the answer helpful.
Upload any reports or prescription if available.
Regards
Dr N Kumar
Neurologist
Take treatment as advised and upload reports
Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
You seem to be suffering from lumbosacral radiculopathy due to compression of nerve root secondary to disc prolapse.
You need to be treated under a neurologist.
You should avoid stooping forward, lifting heavy objects, squatting, sitting crossed leg.
Regular back exercises under physiotherapist guidance.
Pain killers with muscle relaxant like etoricoxib or Aceclofenac with thiocholchicoside or tizanidine can be taken instead of advil.
Pain modulator drugs like pregabalin or amitryptiline or gabapentin can be used.
Injection for pain relief as steroid or anesthetic agents are also option.
In case of non responsive pain, Surgical procedure can be considered after consulting a neurosurgeon.
Hope you found the answer helpful.
Upload any reports or prescription if available.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Prasad
Here is my MRI. My pain has gone from a 9 or sometimes 10 during the first 2 weeks to a 3, maybe 4 at times so there has been progress. When the pain was intense, mostly at night, I took Tramadol, but only for a week. I am seriously considering an injection, after talking to a neuro surgeon that believes surgery is not necessary. I really don't want to go on stronger meds unless that's the only path to feeling better.
Study Result
INDICATION: Left back and leg pain.
TECHNIQUE: Multisequence, multiplanar MRI of the lumbar spine was
performed on 3 Tesla magnet. Obtained sequences include: Sagittal
T1, T2, STIR; axial T2 and T1.
COMPARISON: None.
FINDINGS: The vertebral bodies of the lumbar spine are normal in
size, shape, and alignment . There is normal bone marrow signal
is demonstrated throughout the vertebra. There is mild
intervertebral disc space narrowing at T11-T12 and L4-L5. There
is loss of the usual T2 hyperintense signal at L4-L5.
The spinal cord is of normal volume and contour. The cord
terminates at the mid-L2 vertebral body level. The nerve roots of
the cauda equina and the filum terminale have the usual
appearance.
Specific findings are seen at the following levels:
T12-L1: No spinal stenosis or neural foraminal narrowing.
L1-L2: No spinal stenosis or neural foraminal narrowing.
L2-L3: There is mild bilateral facet arthropathy. No spinal
stenosis or neural foraminal narrowing.
L3-L4: Small broad-based diffuse disc bulge. There is mild
bilateral facet arthropathy. There is no spinal stenosis or
neural foraminal narrowing.
L4-L5: Small broad-based diffuse disc bulge. There is left
paracentral herniation with extension to the foramen with
Study Result
INDICATION: Left back and leg pain.
TECHNIQUE: Multisequence, multiplanar MRI of the lumbar spine was
performed on 3 Tesla magnet. Obtained sequences include: Sagittal
T1, T2, STIR; axial T2 and T1.
COMPARISON: None.
FINDINGS: The vertebral bodies of the lumbar spine are normal in
size, shape, and alignment . There is normal bone marrow signal
is demonstrated throughout the vertebra. There is mild
intervertebral disc space narrowing at T11-T12 and L4-L5. There
is loss of the usual T2 hyperintense signal at L4-L5.
The spinal cord is of normal volume and contour. The cord
terminates at the mid-L2 vertebral body level. The nerve roots of
the cauda equina and the filum terminale have the usual
appearance.
Specific findings are seen at the following levels:
T12-L1: No spinal stenosis or neural foraminal narrowing.
L1-L2: No spinal stenosis or neural foraminal narrowing.
L2-L3: There is mild bilateral facet arthropathy. No spinal
stenosis or neural foraminal narrowing.
L3-L4: Small broad-based diffuse disc bulge. There is mild
bilateral facet arthropathy. There is no spinal stenosis or
neural foraminal narrowing.
L4-L5: Small broad-based diffuse disc bulge. There is left
paracentral herniation with extension to the foramen with
Brief Answer:
Take treatment as advised
Detailed Answer:
Hello,
Mri report is suggesting L4-5 disc prolapse with narrowing of exit foramina and compression of nerve root.
If there is no sensory or reflex loss and no weakness then medications may be sufficient.
You can also go for intrathecal injection.
As surgery is not required at present, focus on precautions and physiotherapy along with medication.
Pregabalin or gabapentin will be of great help.
Regards
Dr N Kumar
Neurologist
Take treatment as advised
Detailed Answer:
Hello,
Mri report is suggesting L4-5 disc prolapse with narrowing of exit foramina and compression of nerve root.
If there is no sensory or reflex loss and no weakness then medications may be sufficient.
You can also go for intrathecal injection.
As surgery is not required at present, focus on precautions and physiotherapy along with medication.
Pregabalin or gabapentin will be of great help.
Regards
Dr N Kumar
Neurologist
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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