Thursday, September 10, 2009

Understanding the results of an MRI of the Lower Spine-Herniated disc

A recent question posted regarding Herniated disc

Subject: Understanding the results of an MRI of the Lower Spine


About 2 years ago I was doing a relaxation/Yoga course in NYC and I started to feel tingling in my back. By the end of the program (4 days later) I had severe pain in my lower back and could not sit up for any amount of time. I also found that I was standing bent (to one side) since that was the only relief I could get.

After 3 months of limited mobility I strapped myself up with elastic bandages to hold myself up straight and I found relief.

In July (just over 2 years later) I lifted a heavy suitcase and once more the the pain in the lower back re-started . The problem now is that it is radiating down my left leg, specifically from the side of my buttock down the side of the left leg just above my ankles. Further, I have difficulties walking and if I walk excessively I have numbness in my toes.

I went to a doctor who said I should rest, but now since the problem has gotten a bit more painful he has ordered a MRI.

Could you please explain to me the results:

It says as follows:

There is straightening of the lumbar spine with loss of lumbar lordosis due to paraspinal muscle spasm.

There is loss of T2W signal with complete loss of Height of L4-L5 disc due to desiccastion of the prolapsed disk material. Posterior central and left paracentral extrusion of nucleus pulposus of L4-L5 disc (8-9mm) with compression of the thecal sac and left L5 nerve root in the lateral recess.

The rest of the lumbar vertebrae and discs appear normal. The pedicles, laminac and spinous processes appear normal. The posterior facet joints appear normal. No evidence of any fracture, bone contusion or bone infection seen. No evidence of any bone erosion or destruction seen. The spinal cord appears normal. No definite mass lesion is seen. The conus medullaris and cauda equina appears normal. the pervertebral muscles appear normal.

Thank you for any help provide

The disc material has herniated and is pushing on your nerve root (this is called Sciatica)that would explain the numbness is the toes and difficulty in walking.
Surgery is one option or you may want to consider looking into Non-surgical spinal decompression.
The type of disc herniation you have presents a challenge.
I would recommend that you have a NCV and EMG ordered to see if the nerves are effected and the degree of severity.
In our practice we see patients that have herniated discs and they do great on the spinal decompression table BUT once the disc is extruded 8-9 mm it does make the case more challenging and I would recommend that you have a Neurosurgical consultation to further understand the condition.
Good luck.....

Spinal Decompression works?

Subject: Spinal Decompression For Sports Injury
Question: Hello Dr Shoshany-

My name is Jason. I suffered from a hockey related injury 10 years ago which caused a degenerative disc (i believe the 4L or 3L). At the present time i am in no pain and can handle most exercises without any problem, however, whenever I attempt to play hockey the injury gets severely aggravated and I am essentially paralyzed for a week. Its usually a long, sudden and intense stride that will cause the back to "pop". My question is do you feel i would be a good candidate for decompression? My only fear is that the technique will actually make the injury worse. If it works will I be able to play hockey again or is it just too risky? I would appreciate your feedback - thanks a bunch!

I don't think that if an activity makes your condition worse that you should continue the activity.
Spinal decompression can be very effective in reducing your symptoms.
I would seek out a spinal decompression specialist that can carefully evaluate your recent MRI to determine if you are a candidate for this procedure. This treatment is not for everyone and is not for all types of back injuries. If you have a bulging or herniated disc or a spinal stenos is then consider this treatment.
If you decide to move forward with this treatment you should lay off the activity until you fully recover. What I like about this treatment is that it is very safe and the only real side effect I have seen in 7 years is soreness that goes away once the treatment stops.
Hope this info helps.
Steven Shoshany DC, CCEP
Manhattan Herniated disc treatment

Excercise with Oxygen therapy in NYC

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About Oxygen: What’s the first thing ER technicians put on your face after a major injury? An Oxygen mask. Did you suddenly forget how to breath the air everyone else is? Are you unable to get enough oxygen because you’re injured (assuming your lungs are ok)? None of the above. Oxygen reduces the stress your body will endure. Stress is an oxygen killer. Lack of oxygen kills cells and slows down brain function and other organs. We are all aging due to enzymatic systems failure which are responsible for the body’s uptake and utilization of oxygen. If a cell is deprived of oxygen, it dies. If the cells die, you slowly start to die. If this happens often enough, you begin to age (and fast). In fact, cancer thrives in oxygen poor environments. So why do you need to increase the oxygen during exercise? Isn’t exercise the way to a long healthy life? Yes and no. Consistent strenuous exercise requires a great deal of oxygen. Your body burns the existing oxygen in your red blood cells, regardless of how much you are breathing in. It’s not the quantity of O2, its the purity that is important. You are using far more oxygen than you are taking in. Your oxygen levels (pO2), measured in millimeters of mercury, should be between 85 and 100 depending on your age. Many doctors will advise that your low score "... is normal for your age." It’s true that it’s normal, but it’s only normal because 99% of people don’t know that it doesn’t have to be low and you can keep it high where it belongs! It is the single easiest step you can take to help prevent cancer, premature aging, illness and more. Walk into any gym... notice how many people look great from the neck down? Why does everyone look older than they should? It’s true they’re burning calories and building muscle, but many are not aware they may be aging themselves at a greater rate and increasing the opportunity for many illnesses unless they are performing EWOT.

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How are we getting more oxygen by increasing the saturation level we breathe normally?
A red blood cell carries no more than 97% oxygen. Many will argue that you cannot force another 3% into the cell. This is true. However, additional oxygen is absorbed by the plasma (which carry the red and white blood cells) and is then pushed into the body’s cells & deep tissues without the aid of the red cells. This is called the Law of Mass Action. Very little oxygen actually gets through, but if you are consistently feeding your body the extra oxygen, there will be an extensive increase in your total tissue oxygen level. The goal is to keep the oxygen level of your blood at 100 points for your entire life.

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