Back and Neck Injury/Back Pain
My wife at 68 & of 36kg,is suffering of back pain due to bulging at L4/L5 & protusion at L5/S1.Her such issue is repetitive-2003.2008.2011 & July 2014.
After viewing MRI Neurologist prescribed-Shelcal-M twice/day & Cholecalciferol once/week.he also prescribed Calcitonin Nasal spray in alternate nostril.
She is also advised rest & some excercise.(So far, orthopedic surgeon gave pain killer & asked for rest & excercise.)
She does have Varicose,on Left Leg,since last 30 years & Vascular surgeon,opined to consult Neurosurgoen,this time,as her pain is predominantly on Left side only.
Whether this treatment for three months will resolve the issue?
Are you anticipating surgery?Do you feel some degeneration of bones in Spine?I submit the comments of Radiologist on MRI.
You may kindly review & opine about treatment plan & also advise to take preventive steps to combat against recurrence.
MRI Scan of Lumbar Spine. Rekha Desai-68.
MRI was performed using T1/T2Wsequences in multiple planes.
Mild scoliosis of dorso-lumbar spine is seen towards left side.Mild exaggerated lumbar lordosis is noted.Mild degenerative lumbar spondylotic changes are seeen in the form of marginal osteophytes & multilevel disc dessication.Patchy hyperintensity of spine is seen on T1W/T2W images.
Correlation with BMD is sggested to rule out Ostenpenia V/S osteoporosis.(Since 2003,she is taking Rocaltrol-0.25mg once/day)
Mild posterior disc bulge with small left foraminal disc protrusion is seen at L3-L4 level,partially effacting anterior subarachnoid space & indenting existing L3nerve root.Mild left neural foraminal narrowing is noted at L3-L4level.
Small postero-central disc protrusion is seen at L5-S1 level,effacting anterior epidural fat,indenting both traversing S1nerve roots.Bilateral mild neural foraminal narrowing & mild central spine canal narrowing(11.1mm)is noted at L5-S1 level.
Diffuse posterior annular disc bulge is seen at L4-L5 level.
Minimal posterior disc bulge is seen at L2-L3 level.
Mild facetal arthropathy is seen from L3-L4 to L5-S1levels.
Mild ligamentum flavum thickening is noted at L4-L5 & L5-S1 levels.
Thin fatty filum terminale is noted at L2-L3 level.
No central spinal canal stenosis is seen in this study.
Distal cord & conus appear normal.Both SI joints are normal.
No pre/paravertebral,epidural soft tissue or haematoma is seen.
Bilateral psoas & posterior paraspinous muscles are normal.
Dr.Kindly appreciate our anxiety level & respond.
GOD bless you.
With warm regards,
Sorry to hear about your wife.
The MRI does not give the impression that surgery is needed, however, it really depends on her symptoms. The symptoms and MRI must be correlated with physical findings from an orthopedic and neurological exam. The only questionable thing from the MRI would be the Patchy hyperintensity, which the location(s)is not stated. Not sure if this would indicate Modic changes, which might explain some of the ongoing pain and failure to resolve any herniations.
The level of degeneration would seem to be in accordance with her age.
I would think that a spinal injection might be indicated before any surgery, to see if that would offer any relief. Physical therapy might help, specifically any response to some mild traction and/or McKenzie diagnosis and therapy approach.
Kind regards, and I do hope your wife will get treatment that will help.