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RH
RH, Board Certified Neurologist
Category: Neurology
Satisfied Customers: 1946
Experience:  Expert in various areas of Neurology
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What is disc desiccation with loss of disk height and a left

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What is disc desiccation with loss of disk height and a left paramedian broad-based osteophyte and disk bulging that protrudes somewhat beyond the confines of the osteophyte? The bulging disk has a maximum AP diameter of 3mm. There is also severe left facet hypertrophy. The combination of the bulging disk and facet hpertrophy appears to impinge on the transiting left nerve root within the spinal canal at this level. There is a moderate left facet effusion and moderate right facet hypertrophy. Therre is contact with the transiting tight root but not circumferential impingement
Submitted: 3 years ago.
Category: Neurology
Expert:  RH replied 3 years ago.
Hello!

The interpretation of these findings is as follows:

Disc dessication means drying out of the disc which provides the cushion between the two bones on the spine (vertebral bodies) - when this disc dries out , it collapses on its own and causes loss of the disc height and the disc matter bulges out of its space (imagine eating a peanut butter sandwich and squeezing the two slices of bread together which makes the peanut butter squirt out (peanut butter = disc). This bulging of the disc can compress upon the nerve roots which come out of the spine and innervate the muscles of your legs. Osteophytes are bone spurs which are reactive inflammatory changes of the bone due to arthritic development. Facet hypertrophy is the thickening of the bones at the facet joint (the two joints that keep each vertebral body - bone of the spine in its place). Effusion at these joints is fluid accumulation as our immune system tries to fight the inflammation of the bones (inflammatory response) - all of these changes causes pain, nerve root compression and decrease in mobility and flexibility of the spine.
Customer: replied 3 years ago.
Could any of this been caused by an injury?
Expert:  RH replied 3 years ago.
Yes reactive arthritic changes of the spine can occur post injury.
Customer: replied 3 years ago.
At L5-L6 there is disk desiccation with loss of disk height and a left paramedian broad-based osteophyte and disk bulging that protrudes somewhat beyond the confines of the osteophyte. The bulging disk has a maximum AP diameter of 3mm. There is also severe left facet hypertrophy. The combination of the bulging disk and facet hypertrophy appears to impinge on the transiting left nerve root within the spinal canal at this level. There is a moderate left facet effusion and moderate right facet hypertrophy. There is contact with the transiting right root but not circumferential impingement. There is also moderately severe left neural foraminal narrowing with both posterior and inferior contact with the exiting left foraminal root due to facet change and bulging disk, and there is moderate inferior right neural foraminal narrowing secondary to bulging disk and small osteophyte. It contacts the exiting right foraminal root but without circumferential impingement. I hurt myself and wondering if this could of been caused by the lifting of wire overhead, I have been experiencing pain in my back and it radiates at times down to my leg, losing control of ability to urinate with control. Sleep and pain are a constant companion now. What do you suggest I do?
Expert:  RH replied 3 years ago.
Given your young age and the symptoms you described including urinary problems, I would highly recommend neurosurgical evaluation for either epidural steroid injection and if that doesnt work then for lumbar decompression and fusion.
Customer: replied 3 years ago.
At l4-l5, there is disk desiccation with loss of disk height and a grade 1 retrolisthesis of L4 on L5. There is a diffuse posterior disc bulge relating to this measuring 3 mm in maximum AP diameter. There are moderate bilateral facet effusions. There is no evidence of significant mass effect on neural elements. There is mild neural foraminal narrowing. AT L3-L4, there is a grade 1 retrolisthesis of L3 on L4 and disk desiccation with loss of disk height. There is a small diffuse posterior osteophyte and traction disk. The combination of the retrolisthesis and small osteophyte measures an anterior-posterior diameter of 4mm. This indent the ventral thecal sac but there is no evidence of significant mass effect on neural elements. There is mild inferior neural foraminal narrowing bilaterally but no foraminal root impingement.
Expert:  RH replied 3 years ago.
I would recommend going for surgery given all these findings as these changes will likely get worse with age if not fixed soon.
Customer: replied 3 years ago.
I hurt myself and am wondering if there is a surgical procedure to address and correct nerve damage and bulging dis issues, have already had injections with no positive results? what type of surgery would it be going in for and how much downtime can I anticipate?
Expert:  RH replied 3 years ago.
the surgery would involve dissectomy (shaving of the disc), facetectomy and foraminotomy (decreasing compression on the nerve root), and stabilizing the spine with fusion. Downtime generally for this would be around 4 weeks with physical therapy.
RH, Board Certified Neurologist
Category: Neurology
Satisfied Customers: 1946
Experience: Expert in various areas of Neurology
RH and 2 other Neurology Specialists are ready to help you
Customer: replied 3 years ago.
Would it be possible for me to fax the imaging report to you and you give me a report on what should be done?
Expert:  RH replied 3 years ago.
I am a Neurologist and based on the information about your symptoms and MRI report that you have typed here, you seem to be a good surgical candidate. The exact laying out of a plan for surgery of what detailed procedure required is done by a neurosurgeon. So I would recommend taking the MRI films to the neurosurgeon who would be doing this procedure for you.
Customer: replied 3 years ago.
Can I submit the MRI report to you via fax to insure all the information I submitted is accurate? There were a few other lines which I did not address and would like to know how to handle this.
Customer: replied 3 years ago.
To insure all the information is available to your professional I have decided to type in all information, unable to fax or scan document. Clinical: This is a patient with low back pain which is chronic and occasional right-sided radiculopathy. Technique:Sagittal 4.5 mm thick turbo spin echo T2 weighted and STIR images are obtained through the lumbosacral spine,as well as T1 weighted spin echo images. Axial turbo spin echo T2 weighted images are obtained with a 5 mm slice thickness from L2-3 through L5-S1, as well as T1 weighted spin echo emages. Findings: There is evidence of a transitional vertebra. For the purposes of this report, the inferior most full sized disk will be termed L5-L6, and the smaller disk below L6-S1. X-ray correlation is strongly recommended. At T11-T12,T12-L1, and L1-L2, there are Schmorl's nodes affecting the endplates. At L1-L2, there is no evidence of other focal abnormality. At L2-L3, there is disk desiccation and a mild grade 1 retrolisthesis of L2 on L3.Minimal 2mm posterior disk bulge is noted with mild mass effect on the ventral thecal sac but no evidence of significant mass effect on neural elements. There is a small left facet effusion. At L3-L4, there is a grade 1 retrolisthesis of L3 on L4 and disk desiccation with loss of disk height.There is a small diffuse posterior osteophyte and traction disk. The combination of the retrolisthesis and small osteophyte measures an anterior-posterior diameter of 4 mm.This indents the ventral thecal sac but there is no evidence of significant mass effect on neural elements.There is mild inferior neural foraminal narrowing bilaterally but no foraminal root impingement. At L4-L5, there is disk desiccation with loss of disk height and a grade 1 retrolisthesis of L4 on L5. There is a diffuse posterior disc bulge relating to this measuring 3 mm in maximum AP diameter. There are moderate bilateral facet effusions. There is no evidence of significant mass effect on neural elements. There is mild neural foraminal narrowing. At L5-L6 there is disk desiccation with loss of disk height and a left paramedian broad-based osteophyte and disk bulging that protrudes somewhat beyond the confines of the osteophyte. The bulging disk has a maximum AP diameter of 3mm. There is also severe left facet hypertrophy. The combination of the bulging disk and facet hypertrophy appears to impinge on the transiting left nerve root within the spinal canal at this level. There is a moderate left facet effusion and moderate right facet hypertrophy. There is contact with the transiting right root but not circumferential impingement. There is also moderately severe left neural foraminal narrowing with both posterior and inferior contact with the exiting left foraminal root due to facet change and bulging disk, and there is moderate inferior right neural foraminal narrowing secondary to bulging disk and small osteophyte. It contacts the exiting right foraminal root but without circumferential impingement.There is also moderately severe left neural foraminal narrowing with both posterior and inferior contact with the exiting left foraminal root due to facet change and bulging disk, and ther is moderate inferior right neural foraminal narrowing secondary to bulging disk and small osteophyte. It contacts the exiting tight foraminal root but without circumferential impingement. At L6-S1, there is no evidence of focal abnormality. The conus is in a normal location and is of normal signal intensity and caliber. I went ahead and typed in the information word for word off of the report could you please elaborate further on suggested treatments or what it is I need to do or expect? Thank you
Due to the amount of time you are investing I will insure to add a tip for this extra work. Due to my injury, I am limited on income right now, rest assured I do appreciate any assistance that can be provided. Thanks again
Expert:  RH replied 3 years ago.
To add to the previous explanations of the findings, there is also spondylolisthesis - meaning slippage of the one vertebral body over the other causing further instability due to all the arthritic changes mentioned above. Retrolisthesis of L3 on L4 means that the L3 is slipped backwards on L4 and L4 on L5 means the same. This problem leads to misalignment of the spine and increases discomfort and pain in mobility. Given these findings that you have mentioned in addition to the previous report, I am pretty convinced that surgery is your best option. I would recommend seeing a neurosurgeon with your MRI films at the earliest.
Customer: replied 3 years ago.
Thank you for the information, now this could of been caused by an injury correct?
Customer: replied 3 years ago.
Hello RH, I hope you are the individual who answered my original question, I have provided a tip and hope you receive it. Thanks for all the help. The question which I asked earlier before submitting all the extensive information above, concerning whether this injury could of been caused by the lifting of an object overhead with a twisting motion and holding up and securing it by the use of a screw gun could of been a result of this injury? Your opinion would be appreciated.
Thank you,
Tom
Expert:  RH replied 3 years ago.
Hi Tom!

Yes these changes in the spine can be caused due to injury and the wear and tear of motions you described above.
Customer: replied 3 years ago.
No additional information needed at this time, but I would like to thank RH for the excellent service he provided. I took his advice and sure enough without even mentioning RH's suggestions the orthopedic doctor I saw followed through with the identical recommendations RH provided. Thank you RH, you helped me to better understand why I have been in so much pain. Understanding this help me to better prepare for what might or might not happen.
Tom
Expert:  RH replied 3 years ago.
you are most welcome Tom! If you ever need to get in touch with me again, you can just write RH is front of your question so i know to look into the post. All the very best and wish you the best of health!
RH, Board Certified Neurologist
Category: Neurology
Satisfied Customers: 1946
Experience: Expert in various areas of Neurology
RH and 2 other Neurology Specialists are ready to help you

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RH
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Expert in various areas of Neurology