Can anyone help me interpret these MRI findings?

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vikasgupta10

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MRI of LUrabO SACRAL SPINE

The luraber and sacral vertebra are normal in alignmnet
The Vertebral bodiws and posterior elements are normal in morphology ,No Collapse
bone destruction is seen,Normal marrow signals are present
small posterior central disc protrusion is observed at L4-L5 level indenting thecal sac.
Rest of the disc appear normal
The facet articulation and neural foramina appear normal
No evedence of primary canal stenosis
conus medullaris and cauda equina appear normal
sacro;iac joints appear grossly normal
the perivertebral soft tissues are unremarkable

Impression :Small posterior central disc protrusion at L4-L5

Additional Details
My Doctor has advised me to do posterior decopression,posterior stabilization and fusion with cages , Do i really need this? will it be manage with medicin?
 
Oh my goodness. I can't see any reason he would want to do a fusion based on these findings, but please keep in mind that I'm not a doctor! What are your symptoms and how bad are they? Where is the pain and what kind of pain do you have?

I would urge you to take your films to get a second opinion, preferable an Orthopedic Spine Specialist. In general, it has been my experience that they are less likely to jump into surgery and will try to find other methoRAB to control your pain. But most certainly, get another opinion before ever considering surgery. This slightly bulging disc does not appear to be putting pressure on nerves or your spinal cord.

I hope you will return and let us know how you are doing and also take time to answer the questions I asked. Those answers might help me to help you.

Best wishes.

Carol
 
Hi, I just had my fourth spinal surgery, an open ALIF fusion on L5-S1 so this is all fresh in my mind and my aching butt/back :) Consider asking your doc how he can tell from these tests whether or not there is an annular tear from this disc. Even though your bulging disc might not be pressing directly on nerves, a bulging disc that has a "tear" can actually leak fluid. If your symptoms are recent, there is a chance that the fluid will "run out" and stop irritating surrounding nerves and tissue. There is also a chance, as in my case, where the pain from the tear continued for over 4+ years**** In the mean time, I had severe neck problems operated on. Eventually, I couldn't take the leg pain and opted for another fusion although it is riskier because I also have bulging discs at the two adjacent levels up (L4-5 and L3-4). I am risking further problems because when you have a fusion, it puts more strain on the adjacent levels, potentially causing them to go bad in the future. So, consider this before you agree to a surgery. Although the idea scared the &*^%%$#@ out of me, I agreed to a discogram. The results of this discogram, and a myelogram, told the docs where the pain was originating from, increasing the likelyhood that the surgery will be effective. Apparently MRIs and CTs alone often cannot do this. ASK A LOT OF QUESTIONS!!!!!!!!!!!!!!
Good luck.
P.S.: There are a lot of great, supportive people on this message board.

Anterior discectomy & fusion at C4-5, C5-6, C6-7
Anterior discectomy & fusion at C3-4
Posterior discectomy/revision due to pseudoarthrosis (failure to fuse) and re-do of
instrumentation at all cervical levels
Ankylosing Spondylitis
Cardiac Pacemaker
Bronchiectasis
VERY recent L5-S1 ALIF with cage & anchoring to hip bone and sacrum
 
P.S.S.
I agree with Maltluver in that you might consider an orthopaedic surgeon. My first two cervical fusions (3)levels were done by a well-known, neurosurgeon highly acclaimed in his field. A lesser known orthopaedic surgeon had to re-do these levels on me and added a fourth level in my neck due to spinal instability. I swear by the orthopaedic surgeon. This one just did my very recent 4.5 weeks old ALIF lurabar-sacral surgery. Although, I mght add that none of them seem to have very great beRABide manner. Oh well, guess we have to compromise somewhere ;)
 
Get a second opinion. The findings that you have posted do not seem serious enough to suggest you require fusion surgery. Perhaps there is something else that you have not posted. Still please get another opinion before you consider this drastic surgery.
 
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