Patient : I had an MRI done today and received a preliminary report. The MRI was ordered as a result of a suspected herniated disc that is causing radiating pain down my right leg (on occasion). My questions are as follows: will this resolve on it's own without the need for surgery - even though at L4-L5, the extruded disc comes in close proximity or abuts the L5 nerve root? For a 31 year old male, are these totally out of line findings and will my back have multiple issues in the future as a result? I'm concerned this may affect my quality of life down the road, being a young active male.
Thank you for any help or guidance that you can offer.
Alignment of the lumbar spine is normal There is moderate L4-L5 and L5-S1 degenerative disc disease. No osseous lesions or areas of marrow edema are identified. A small fissure is seen in the posterior annulus fibrosis at L4-L5. The conus medullaris terminates normally at the mid L2 level.
From T12-L1 through L2-L3 there is no significant disc protrusion or extrusion, central or neuroforaminal stenosis.
At L3-L4 there is a minimal disc bulge without central or neuroforaminal stenosis.
At L4-L5 there is a focal moderate size right paracentral extruded disc with focal compression along the anterior right thecal sac. This is in close proximity to the right L5 nerve root and is suspect for right L5 radiculopathy. There is no central or neuroforaminal stenosis at this level.
At L5-S1 there is a small central posterior disc protrusion without central or lateral recess stenosis. There is mild bilaterial front-back neuroforaminal stenosis.
1. At L4-L5 a focal right paracentral extruded disc comes in close proximity or abuts the right L5 nerve root and is suspect for L5 radicular symptoms.
2. Other less severe degenerative changes as described without other areas of significant central or neuroforaminal stenosis.
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