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Forum Name: Spinal problems and back pain

Question: Bulging & extruded discs/DDD/stenosis


 nsblife - Sat Apr 18, 2009 9:39 am

So the MRI says:
Mild diffuse bulge with paracentral extrusion with caudual migration of the nucleus pulposus of L5-S1 disc indenting the thecal sac and compressing the right descending S1 nerve root canal stenosis is present at this level moderate diffuse annular bulge of L4-5 disc indenting the thecal sac and partially obliterating the forminal fat mild diffuse bulge of L2-3 disc and DDD.Questions: I am an active 31yo male. I am not so much concerned about pain that I can control with rest periods and NSAIDs. I am concerned with my quality of life. I am currently unemployed with no insurance.That said, I would like to continue to enjoy activities like surfing,boating,snorkeling,golfing, and yard work. May I continue these activities when I feel up to it? Any info is greatly appreciated!
 Tom Plamondon PA-C - Mon Apr 27, 2009 11:01 am

User avatar Hello,

Any disc bulging in the lumbar spine that compresses the thecal sac AND causes neurological symptoms should be evaluated by a neurosurgeon. (The surgical treatment is decompression...laminectomy).
Since the spinal cord stops at around L1 then any nerve tissue below this in the spinal canal is considered nerve roots (the collection is called cauda equina). Compression of the cauda equina (housed in the thecal sac containing spinal fluid) can cause some major neurological problems.
I would recommend discussing all the options with a neurosurgeon.

Take care and let us know how it goes.
 nsblife - Wed Apr 29, 2009 11:24 am

Thnak you for the reply. I am a bit confused howeer. What indicates that it is/will cause neurological symptoms? Can I enjoy activities when pain is in check until I can see a Dr about this? Nay be a few months. Thanks for any info!
 Tom Plamondon PA-C - Tue May 05, 2009 11:49 am

User avatar Hello,
A mild disc bulge without symptoms should allow you to do your regular activities of daily living.

Prevent worsening the disc bulge by lifting properly and avoid combined bending and twisting.

The indication for neurological problems with a disc bulging are: numbness, tingling, pins and needles, and muscle weakness in the lower limbs. Also numbness in the perineal area (lower pelvic area) and inability to urinate are signs of cauda equina syndrome.

Take care.

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