QuestionDear Sir,
My father in law had been suffering with a pain since over 6 months now in his left leg below & behind knee level. Have been continuously visiting a local doctor there and seeking medication but no results of pain reduction. Last week the Dr. had asked to undergo MRI SCANNING. Report of which reads as below.
FYI. Age of Patient is 62 years and is still working as an Electrician. I just wanted to know more about this report on the basis of Seriousness, and the right kind of treatment required.
Request you to put some light over the below MRI REPORT.
MRI REPORT - LUMBOSACRAL SPINE
TECHNIQUE:-
Without IV contrast.
SE, TSE & IR sequences
T1W, T2W sagittal & axial
STIR coronal
OBSERVATION:-
Lumbar lordosis is lost.
The vertebral bodies, pedicles, laminae, spinous and transverse processes show normal MR morphology, alignment and signal pattern. No evidence of fracture or dislocaton is seen. Mild facetal arthopathy is seen at all lumbar levels. The bony spinal canal appears normal at each level.
L3-L4, L4-65 and L5-S1 discs are desiccated.
L3-L4 disc shows diffuse bulge with left posterolateral annular tear abutting the left exiting nerve root.
L4-L5 disc shows diffuse bulge indenting the thecal sac and both traversing nerve roots.
L5-S1 disc shows diffuse bulge with posterocentral anullar tear indenting the thecal sac and right transversing nerve root.
The conus medullaris and roots of cauda equina appear normal. No obvious demonstrable intra or extramedullary SOL seen.
The pre and paraspinal regions do not show any demonstrable pathology.
The canal measurements are as follows:
L1:14.1 mm L2:13.1 mm l3:13.5 mm L4:11.22 mm L510.5 mm
IMPRESSION:-
MRI features are suggestive of degenerative lumbar spondylosis as described above.
Answer"L3-L4 disc shows diffuse bulge with left posterolateral annular tear abutting the left exiting nerve root."
This is what is likley causing his symptoms. This is a degenerative, damaged disc, pinching the L4 nerve root. He has similar findings at several levels. Also have the knee xrayed for arthritis.
Chiropractic, traction or spinal decompression therapy should really help this. If is does not improve or worsens, a neurosurgeon should evaluate him.
Ask the doctor to about prescribing a steroid dose pack to really knock down the symptoms in the meantime.