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Doctors Lounge - Orthopedics Answers
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| godolphins1985
- Wed Dec 21, 2005 8:44 pm |
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I am 20 years old and recently in october got hurt at work and had an MRI done...the impressions listed: At L5-S1 there is 2mm Anterolisthesis with bilateral L5 pars defects....there is biforaminal stenosis at this level impinging the L5 nerve roots. There is mild broad based disc bulge......Mild disc bulge with chronic focal extrusion at L4-5 ...there is borederline canal stenosis without signifant nerve compresse.....what does this mean for me
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| Dr. Safaa Mahmoud
- Thu Aug 17, 2006 1:35 pm |
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 Hello,
Degeneration of the disc tissue makes the disc more susceptible to herniation (rapture).
Each disc is formed of a central gel-like inside (nucleus pulposus), surrounded by an outer ring (annulus fibrosus).
When this softer component ruptures (herniates) through the outer ring it press directly on nerve roots and irritate adjacent nervous tissue.
Degenerative changes lead to spinal instability (degenerative spondylolisthesis).
The report says that you have these changes in lumbar vertebra number 4 L4 and 5 L5 but with no significant nerve compression.
The changes between the lumbar vertebrae 5 L5 and the first sacral vertebrae 1 S1causes compression on the nerve root L5 which clinically results in sciatica symptoms (back pain radiating to the legs).
These conditions can be treated in the majority of cases with medical and conservative treatment (non surgical).
Non surgical treatment include, physical therapy, certain exercises, weight reduction, epidural steroid injections, non-steroidal anti-inflammatory medications, and decreased daily activities. The pain usually improves faster than the numbness and the weakness if present.
Surgery for cervical disc herniation is only considered if symptoms are not controlled after at least one month (6 weeks) of medical and conservative treatment, or in very complicated cases with serious symptoms.
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