Just had a myelogrom of my low back and wanted to know what the findings meant and what are some treatment opt?
Bilateral laminectomy is present at the lumbosacral level, designated L5-S1 There is a diffuse 4-5 mm combined hard and soft disc protrusion at L5-S1 indenting the dural sac, reaching both S1-root sleeve origins, and extend about 5mm caudally. There is no associated stenosis. Neither S1 root sleeve fills distally on the myelogram. There are only four non-rib bearing lumbar type segments. Bilateral mild flaval hypertrophy and facet joint arthrosis is present at L4-5
I am a 26 year old female. I have already tried therapy in water and on land which caused more pain I have also had an injection and had to have a blood patch and would consider that treatment again. I have had neck surgery and three back surgeries and do not wish to have and more and it would also be helpful to let you know that i was in a bad car accident last year which required the operations.
You apparently have 4 lumbar vertebrae rather than the more common 5 so the numbering system used in the report may be in error. For example L5-S1 may actually be L4-S1 as there may be no L5 vertebrae. A bilateral laminectomy by definition creates an area of instability at this level. The disc protrusion is a problem as it not only indents the sac but it completely prevents the dye from reaching the S1 nerve roots. This means that the S1 nerves are being impinged and the solution – I am sorry to say – is surgical. The surgery may be a fusion or a metal cage artificial disc. Flavium hypertrophy and facet arthropathy are not significant findings. Epidural steroid injections are not recommended. A person in your circumstance should consult with a neurosurgeon rather than an orthopedic surgeon. I would also recommend that you go to a major medical center with a teaching hospital as your back presents quite a challenge and you are too young to end up ‘disabled’. If I may be of further assistance please let me know. I wish you the very best of health and in all things may God bless. JR
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