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Back Problems Message Board

Back Problems Board Index

I can tell you what might occur in the US but I know treatment and the medical professionals you'll see will be different.

The MRI is just one piece of the diagnostic puzzle. The doctor will look at the images and will correlate what the images tell him to what he finds upon physical exam, neurologic exam and from listening to your description of your symptoms and what type of impact they have on your life.

Basically all the lumbar spine is normal except for the issues you have at the last lumbar disc, referred to as Lumbar 5-Sacral 1. It is showing degenerative changes, including a protruding disc. The disc space has flattened significantly due to the disc losing its "plumpness." This results in the L5 and S1 vertebrae moving closer together, which can sometimes result in a spinal nerve getting a bit squished. The report is not indicating that this is happening...but the disc space has been lost.

The disc protrusion is located right in the middle -- this means it is not pushing out to the left or right side...There are some osteophytes which are like little bone spurs. As the disc begins to degenerate, the body lays down osteophytes in an attempt to stabilize this segment of the spine. Unfortunately the result is that the osteophytes take up space in two areas where the nerves need to be able to exist without impingement, the central canal, and the foramen, which are openings at each pair of vertebrae where the spinal nerves exit the spine out to the limbs of other parts of the body. When there is a narrowing, caused by things like osteophytes or discs that are bulging out of the disc space, this is often a source of nerve compression, and thus, nerve pain. This narrowing is called "stenosis."

This may be more information than you want...but you'll notice the report refers to the traversing nerve root. The nerve roots run in a longitudinal fashion (traversing nerve roots) before they exit (exiting nerve root). The neural foramen at the L5-S1 level is labelled the L5-S1 neural foramen. The nerve root that exits at this level is the exiting L5 nerve root. The S1 nerve root is called the traversing nerve root at this level because it traverses the disc space at this level in the spinal canal before it exits out of the neural foramen one level lower at S1-S2. Hence, a paracentral disc protrusion L5-S1 level will affect the S1 traversing nerve root, but a foraminal or far lateral disk herniation at L5-S1 will affect the exiting nerve root which in this case is L5. It's a little confusing, but I hope you see the difference. (pull up an illustration of the spine and check out the nerves as they come out of the spine -- then it will be easier to understand ).

The problems caused by the disc protrusion are affecting the traversing S1 nerve. However, the report indicates that this finding does not correlate with what you are reporting in the description of your pain...nothing indicates left side for example, and I guess the S1 nerve root innervates areas that are different from your reported pain.

So the doctor will want to examine you very carefully.

Nothing in your report indicates that surgery would be considered. The nerve compression is described as "mild" which usually means that conservative treatments would be recommended to deal with the pain. This might be a course of physical therapy, oral medications for inflammation and pain, perhaps a series of epidural steroid injections for the same purpose.

Hope this helps you understand the language in the report.

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