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What Does This MRI Report Of Spine Indicate?

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Posted on Sat, 18 Oct 2014
Question: Help with MRI findings please. In pain. I had CES in L5S1 in sept 2012 surgery was delayed and I am left with foot drop I self catheterise. A partial but huge discectomy was done with some remaining disc. Re herniated and a fusion with cage, bone graft and plates February 2013. Never regained bladder control or use of left leg. MRI was performed because of increased pain, weakness and numbness. As well as the report I was sent an appointment for CT to assess movement of hardware. I am in a considerable amount of pain struggling to move or sleep and am worried because of previous Cauda Equina Syndrome. 60mg zomorph morning and night. Also Diazepam amytripiline severedol Here is the full scan report.

Clinical Details:

Cauda Equina since 2012 and lt sided weakness and foot drop
Now complaining of new symptoms of right sided weakness

?spinal cord injury

MRI Spine Lumbar/Sacral : There is metalwork in the L5 and S1 vertebral bodies, with sclerotic changes around the corresponding vertebral body endplates. Elsewhere, vertebral body and disc height is well-maintained and discs well hydrated.

There is a mild diffuse disc bulge at L3/4 extending slightly more to the left side, but no compression of thecal or exiting nerve roots. No significant thecal sac or nerve root compression is seen at L4/5. At the L5/S1 level, there is a central disc protrusion, just contacting ventral surface of thecal sac. On the T1-weighted images, there is some additional soft tissue around the left S1 nerve root within the lateral recess.
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Answered by Dr. Dr. Praveen Tayal (9 hours later)
Brief Answer:
Weakness not due to disc herniation.

Detailed Answer:
Hello,
Thanks for posting your query.
The recent MRI findings do not show any nerve root compression or a significant disc bulge. The right side weakness can be due to a soft tissue compressing the area or due to central causes. The surgery that was done earlier is intact and there is no further disc bulge in the area.
Injury to the back or spinal cord, Lack of blood supply to the legs as a result of plaque formation in the blood vessels, diabetes, stroke, multiple sclerosis and underactive thyroid need to be ruled out under the guidance of your neurologist. Abnormal levels of calcium, potassium, or sodium in your body and a lack of vitamin B12 can also cause such weakness. Do get these levels evaluated.
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
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12307 Questions

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What Does This MRI Report Of Spine Indicate?

Brief Answer: Weakness not due to disc herniation. Detailed Answer: Hello, Thanks for posting your query. The recent MRI findings do not show any nerve root compression or a significant disc bulge. The right side weakness can be due to a soft tissue compressing the area or due to central causes. The surgery that was done earlier is intact and there is no further disc bulge in the area. Injury to the back or spinal cord, Lack of blood supply to the legs as a result of plaque formation in the blood vessels, diabetes, stroke, multiple sclerosis and underactive thyroid need to be ruled out under the guidance of your neurologist. Abnormal levels of calcium, potassium, or sodium in your body and a lack of vitamin B12 can also cause such weakness. Do get these levels evaluated. 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