What Does This MRI Report Of Spine Indicate?

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.

Answered by Dr. Dr. Sudhir Kumar (1 hour later)

Brief Answer:
central disc protrusion may be problem at L5/S1

Detailed Answer:
Hi,

Thanks for your query.

I'm Dr. Sudhir Kumar

After going trough your query I concluded that this MRI report says metalwork (screw and plate fixation) has been done between L5 and S1 vertebrae. between L5 and S1 vertebral end plates there is sclerosis(hard bone). At the L5/S1 level(means disc between lumbar fifth and sacral vertebra), there is a central disc protrusion(disc is coming out at center place ) , just contacting ventral surface of thecal sac(it is touching anterior surface of covering of spinal cord at this level). some additional soft tissue around the left S1 nerve root within the lateral recess ( there is some additional soft tissue around the left S1 root where it is leaving spinal cord sheath through lateral recess). lateral recess is place where root leaves covering of spinal cord.

Other levels seems me near normal(L3/4 and L4/5).

By this finding and clinical symptoms now complaining of new symptoms of right sided weakness, it seems that problem is at L5/S1 level, may be some compression( MRI say just touching ventral surface of dura) by central disc protrusion may be causing problem. Furthermore fusion is already painful. So you may need revision surgery(fixation) with discectomy and bone grafting.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wishing you good health.

Take care

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj