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What Does This MRI Report Indicate?

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Posted on Tue, 4 Nov 2014
Question: my mri result shows small posterior disc protrusion with minimal indentation of the anterior thecal sac is visualised at d3-d4 is it curablle without surgerey - i dont waNT TO DO SURGERY PLS GUIDE ME
doctor
Answered by Dr. Vivek Chail (18 minutes later)
Brief Answer:
Please send complete MRI report and write symptoms

Detailed Answer:
Hi XXXXXXX,
Thanks for writing in to us.

I have read through your query in detail.
The MRI details mentioned in your query suggests a disc degeneration with small disc component protruding in to the spinal canal at D 3 - D 4 level. This is the uppoer back and there is only minimal indentation of the anterior thecal sac (covering of spinal cord). Your problem is a mild one but I wish to read the complete MRI report details.

If possible then please attach your MRI report with your query and also tell me your symptoms so that I can confirm the detailed nature of your MRI findings. From what you have mentioned, it looks like a mild condition which does not need surgery.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Vivek Chail (1 hour later)
Attached the report , as per your advise. Pls give your opinion, withouht surgery is it possible to cure it The symptom is back pain at the time of sleep . and having some sort of stimulation here and there of body some times.
doctor
Answered by Dr. Vivek Chail (42 minutes later)
Brief Answer:
Medications and physiotherapy might help

Detailed Answer:
Hi XXXXXX,
Thanks for writing back with an update.

I have read through your MRI report in detail.
It shows
1. Small posterior disc protrusion with minimal indentation of thecal sac at D 3 - D 4 level in the upper back.
2. Posterior disc bulge at C 3 - C 4.
3. Posterior disc bulge at L 3 - L 4.
4. Posterior disc protrusion with indentation of anterior thecal sac at L 4 - L 5.

The D 3 - D 4 level disc problem is very rare and symptoms from it are reported to be one per million per year and occurs in only 0.25–0.75% of all intervertebral disc herniations. If we consider your case of "Small posterior disc protrusion with minimal indentation of thecal sac at D 3 - D 4 level in the upper back", then this has to be clinically assessed by a neurosurgeon and the pain during sleep or symptoms of stimulation have to be matched with the disc problem at this level.

Your problem is in early stages as mentioned in my previous reply. At this stage more thought must be given to non surgical treatment by medications and physiotherapy. If you do not get relief from medicines and physiotherapy after many months and your symptoms get worse, only then surgery should be thought of.

Medications that can help you right now are
1. Over the counter medications for mild to moderate pain.
2. If over the counter medications are not effective your doctor may recommend stronger prescription pain medication.
3. Anti-inflammatory drugs or prescription NSAIDS (non-steroidal anti-inflammatory drugs) to reduce inflammation following acute injury.
4. Muscle relaxants to reduce acute muscle spasm.
5. Prescription nerve pain medication designed specifically to reduce nerve damage and pain.
6. In moderate pain, injections such as facet injections, nerve blocks or epidural injections. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.

Physiotherapy that can help you right now includes the following
1. Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to improve alignment, mobility and range of motion of the thoracic spine. Use of mobilization techniques also helps to modulate pain.
2. Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen muscles of the back and abdominal muscles to support, stabilize and decrease the stresses place on the disc and back.
3. Neuromuscular Reeducation (NMR) to improve posture, restore stability, retrain the patient in proper sleeping, sitting and body mechanics to protect the injured disc and spine.
4. Modalities including the use of ultrasound, electrical stimulation, ice, cold laser, traction and others to decrease pain and inflammation of the spinal structures.
5. Home programs including strengthening, stretching and stabilization exercises and instructions to help in the performance of daily tasks and progress to the next functional level.

Please note that physiotherapy must initially be done under supervision of physiotherapist and most patients like you will respond in 4 - 12 weeks depending on the severity of the symptoms.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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What Does This MRI Report Indicate?

Brief Answer: Please send complete MRI report and write symptoms Detailed Answer: Hi XXXXXXX, Thanks for writing in to us. I have read through your query in detail. The MRI details mentioned in your query suggests a disc degeneration with small disc component protruding in to the spinal canal at D 3 - D 4 level. This is the uppoer back and there is only minimal indentation of the anterior thecal sac (covering of spinal cord). Your problem is a mild one but I wish to read the complete MRI report details. If possible then please attach your MRI report with your query and also tell me your symptoms so that I can confirm the detailed nature of your MRI findings. From what you have mentioned, it looks like a mild condition which does not need surgery. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek