Concluded Case

Multiple Lumbar Intervertebeal Disc disease

New Case . 58 yr ,F, back pain for 3 yrs ,aggravated since 8 months ,difficulty to walk since 6 months with buckling of left knee and fell down on a few occassions sine 4 months. Last fall on 20th june. On exam mild wasting of lt quadriceps . Knee jerk absent bilaterally ,intact ankle jerks but hypoactive .Dulling of sensation L 3,4 ,5 left. Low back surgery done by spinal surgeon. What abnormality in the MRI LS spine ?.

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Concluded answer

Thanks for all answers. Discussion - What abnormality in the MRI LS spine?.MRI LS spine shows- * Mild posterior diss bulge at L1-2,L2-3level with out radicular compression. * Diffuse posterior - small disc central& rt posterolateral at L3-4level mildly intending the anterior thecal sac & traversing nerve roots on the Rt side. * Diffuse posterior, paracentral & posterolateral foraminal disc bulge at L4-5 level intending the anterior thecal sac,bilateral traversing nerve roots & exiting nerve roots on the Lt side. * Diffuse posterior & Rt paracentral disc bulge L5 S1 causing mild indentation of the exiting nerve roots on the rt side * Durgical decompression & fusion of L3-4 ,L 4-5 done under GA. Pt is discharged

All Answers

Thanks for all answers. Discussion - What abnormality in the MRI LS spine?.MRI LS spine shows- * Mild posterior diss bulge at L1-2,L2-3level with out radicular compression. * Diffuse posterior - small disc central& rt posterolateral at L3-4level mildly intending the anterior thecal sac & traversing nerve roots on the Rt side. * Diffuse posterior, paracentral & posterolateral foraminal disc bulge at L4-5 level intending the anterior thecal sac,bilateral traversing nerve roots & exiting nerve roots on the Lt side. * Diffuse posterior & Rt paracentral disc bulge L5 S1 causing mild indentation of the exiting nerve roots on the rt side * Durgical decompression & fusion of L3-4 ,L 4-5 done under GA. Pt is discharged

* Modic changes at L3-L4 endplates and vertebral body * disc herniated at L3-L4, L4-L5, L5-S1 levels * Retrolisthesis at L3 over L4 ?? Experts opinion on detailed analysis

L3 4 5 degenerative disk disease.canal stenosis with retrolysthesis l3 over l4. Now tt conservatively.with physiotherapy.

Lumbar degenerative disc disease L3/4 and L4/5 level severely affected Retrolisthesis L3/4 level Canal stenosis plus

Disc generative changes in lumber spine Prominent PID L4L5 L5 S1.compressing cord .

Multiple pivd marrow oedema