Four different opinions
 

Hi,

After the sport trauma I periodically have severe pain attacks (they started as lower back pain, now the pain goes to the neck and legs). The surgeon I had been consulted by, said, he did not see any problems and suggested taking painkillers while the attacks.

At the same moment, I had the MRI pictures from the hospital. And the hospital doctors' conclusion says "disc desiccation and annular tear".

As my pain attacks continued I decided to get a relief from the conservative therapy and visited a physio therapist. She is sure that "there is obvious disc herniation" on the image (please see it attached). Well, I am taking massage&acupuncture now, but things go worse..

And, this summer, I was spending time in a different country and also underwent an MRI exam there. The written conclusion of their specialists' is: "degenerated discs (L4-L5, L-5-S1), discs protrusions are obsereved".

By this moment, I have four different opinions and this is confusing me.

The question is: who is rights? The surgeon, who does not see anything but prescribes painkillers (well, it looks like he understands I need something from pain but does not see it's cause); hospital doctors who see "disc desiccation and annular tear"; my physio therapist, who sees "obvious disc herniation"; or abroad specialists confirmed "degenerated discs and discs protrusions".

Please see the MRI image attached. Thank you guys for your opinions.. :)

P.S.: Sorry, I have no idea how to post my image other way, so I put this kind. Hope, this does not against the rules.. :confused:

*edit*
how to attach images -
http://neurotalk.psychcentral.com/fa...b3_attachments

The written MRI report might be easier for us to help with, as the images are usually so small and hard to see what they are showing..
Unless you know which image shows the suspected areas clearly.

Welcome Girl_With_Balloon. :Wave-Hello:

Thank you for the answer.

I think, the written report from the hospital differs from that shown on the picture. That is why I ask to see the picture together with the report.

Well... This is the exact words from the Canadian hospital report: "Findings: At L4-5 there is disc desiccation. Annular tear involving the L5-S1 discs. No evidence of disc protrusion".

...from the surgeon report: "Weak hip girdle, particularly abductors, lateral hip pain, secondary GT bursitis." -- no single word about findings from the hospital MRI though he was looking at their report while writing this diagnosis.

...from the Canadian physio therapist: "Multiple spinal discs L4-L5, L5-S1 protrusions are observed from MRI images"

And from the Different Country report: "T1-, T2-, T2*- and PD. T2 images show MP signal reduced (discs L4-L5, L5-S1). Spinal canal: not narrowed. Any other abnormalities or tumors: not observed. Conclusion: Discs L4-L5, L-5-S1 are degenerated."

Thanks Kitt. :)

Hi
you may attach the image of the MRI by downloading it from your computer...Jo*mar left you a link to the info on how to attach images in posts

Thanks. Tried to do this... Hope to get some advice.

I think the confusion lies within what those terms actually mean. You can have an annular tear (a tear in the fibres that coat the disc) without a herniation. Protrusions are when there is a bulge but no herniation. Dessicated means a loss of (for want of a better word) plumpness in the discs, again not a herniation. A herniation is where the annular tear becomes great enough to let fluid out of the disc (imagine squeezing a jelly doughnut). I have had 3 full herniations of L5/S1 (the 1st of which was operated on) and even I'm struggling to get a surgical option as it's just not deemed bad enough. To be honest if I had the choice again I wouldn't have been so quick to have surgery as all back surgery has consequences.

Hope this helps.

That "no evidence of disc protrusion" is poor wording, I suspect they meant to put herniation with it being directly after the comment on tears.

Hi Girl With Balloon, I am also a new member to the site. I have Multiple Sclerosis and am a disabled former ICU RN. By no means am I an expert on neuro or I would not have found this site since I have "left sided protrusions at L2-L3, and L4-L5, per MRI report" and have questions of my own. I do know this information from my own searching for answers prior to seeing my MS Neuro on Monday to be prepared for whatever my doctor says and try to plan for help for us. Here is what I found: People often refer to a disc herniation as a slipped disc. The disc doesn't actually slip out of place. Rather, the term herniation means that the material at the center of the disc has squeezed out of its normal space.

Between the vertebral bones of the spine is an intervertebral disc. The discs provide a cushion or shock absorber for the spine. Each disc is made up of two parts. The center, called the nucleus, is spongy. It provides most of the disc's ability to absorb shock. The nucleus is held in place by the annulus. The annulus is a series of strong ligament rings around the nucleus.

Herniation occurs when the nucleus in the center of the disc pushes or protrudes out of its normal space. The nucleus presses against the annulus, causing the disc to bulge or prolapse outward. The bulged disc material is still contained within the annulus.

But in some cases, the nucleus pushes completely through the annulus and squeezes out of the disc. This is called a disc herniation or protrusion. Herniation and protrusion are two words for the same thing.

If a piece of the disc breaks off, it's called a sequestered fragment. Surgery is almost always needed for sequestration. The loose piece can enter the spinal canal and put pressure on the spinal cord or spinal nerve roots causing serious problems.

J. N. Weinstein, et al. Either Surgery of Nonoperative Treatment Led to Improvement in Intervertebral Disc Herniation. In Journal of Bone and Joint Surgery. May 2007.
I would not consider the PT's opinion too strong unless they are trained to read an MRi or have a degree in reading MRI's.