Expert: John Quackenbush DC - 3/5/2010

Question
what does this mean, At L5-S1 there is a small to moderate sized broad based right paremedian to intraforaminal disc herniated leading to effacement upon the ventral thecal sac and right L5-S1 nerve roots.At L4-L5 in addition to mild to moderate degenerative lateral recess and inferior neuroforaminal narrowing,there is a small central subligamentous disc herniation which is leading to mild effacement upon the ventral thecal sac and exiting L4 nerve roots. this is the impression on MRI what does this mean

Answer
Bradley,

Here is the explanation:

At L5-S1 there is a small to moderate sized broad based right paremedian to intraforaminal disc herniated leading to effacement upon the ventral thecal sac and right L5-S1 nerve roots.

NORMAL SPEAK 1: you have a disc herniation like jelly squirting out of a jelly doughnut that is pressing on the protective coating of the spinal cord and the L5 nerve where it emits from the spine.

At L4-L5 in addition to mild to moderate degenerative lateral recess and inferior neuroforaminal narrowing,

NORMAL SPEAK 2: you have a bony build up (like a callous on your foot) in the area where the nerve emits from level L4/5 this in turn decreases the size of the hole the nerve needs to emit from..so a tight fit usually means more nerve pressure.


there is a small central subligamentous disc herniation which is leading to mild effacement upon the ventral thecal sac and exiting L4 nerve roots.

NORMAL SPEAK 3: The same thing is happening at level L4 as in NORMAL SPEAK 1 but it is more central and not broad based.

(this is the impression on MRI what does this mean)This means you are in a world of hurt and the discs involved are very seriously involved. I suggest you find a chiropractor who offers spinal decompression and get a through exam to see if you are a candidate for this spinal decompression. A neurosurgeon will want to perform a discectomy ( disc removal) and i would see if spinal decompression works first before undergoing the knife.

I hope this sheds some light on youe health issues.

Sincerely,
Dr John Q Quackenbush
Phoenix Chiropractor