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I can't see the Dr. until Sept 15. I am curious to know what all this means.
"At C4-5, there is some central left paracentral small disc protrusion which indents the thecal sac and is just in contact with the anterior cord surface on the axial image #20. There is no cord displacement or narrowing of the canal. It appears to contact the cord slightly inferior to the take off of the ventral nerve root at this level. At 5-6, there is some broad based dorsal disc bulging which is eccentric into the left paracentral region again indenting the thecal sac but this is smaller and does not contact the anterior cord surface. There is some very minimal narrowing of the left sided neural foramen. No central stenosis. This is stable." Anyone know what it means and what might be done about it? Marsha
"At C4-5, there is some central left paracentral small disc protrusion which indents the thecal sac and is just in contact with the anterior cord surface on the axial image #20. There is no cord displacement or narrowing of the canal. It appears to contact the cord slightly inferior to the take off of the ventral nerve root at this level."

The thecal sac is the lining or surrounding of the central nervous system, if you will. In the spinal column, it lines the canal, containing the fluid and the spinal cord it surrounds. So the thecal sac is not "tight" covering the cord but there is space between, of which is filled with fluid. This is why you can have disc protrusion on the thecal sac without compression of the cord and may produce no signs/symptoms. Several studies of asymptomatic people were done and found 30-60% had disc protrusion. So, the findings on the image studies MUST be correlated with your signs and symptoms. This is a flaw in several failed back surgeries. So there is no cord compression at this level, but some ventral nerve compromise, which may relate to your signs/symptoms?

"At 5-6, there is some broad based dorsal disc bulging which is eccentric into the left paracentral region again indenting the thecal sac but this is smaller and does not contact the anterior cord surface. There is some very minimal narrowing of the left sided neural foramen. No central stenosis. This is stable."

Basically the same explanation as in the previous. Again, there is no "cord" displacement. Do you have any signs/symptoms that correlate to these levels? Are they getting worse? Or do you have any problems with the lower part of the body? Why did you have an MRI? Obviously, a second opinion is warranted and sometime required when it comes to surgery. Don't let people scare you about manual therapy, just as surgery. Everyone is different. Actually, if you don't have progressive neurological signs, the direction of treatment should be geared towards noninvasive methods, such as manual methods. This actually follows the natural course disc problems. Many times, the problem can be from the inflammation involved in disc material in places where it doesn't belong, causing irritation to nerve roots.

Don't get me wrong, can't diagnose from just a post, so surgery may not be ruled out yet, but by what you wrote about your report and if your symptoms are not progressive/severe, you may be more of a candidate for a course of noninvasive treatment.

Hope this helped a little. Good luck.

Prouzy





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