s*******y
发帖数: 46535 | 1 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
referring diagnosis: evaluate for herniated disc
technique: multislice multiweighted, 1.5 Teslah
comparison: none
findings:
alignment: no subluxations, there is lumbar levoscoliosis
multilevel degenerative loss of dis aignal and height
vertebral bodies: no compression fractures
L5-S1: within normal limits
L4-5: disc bulge and broad posterior disc protrusion, facet arthrosis and
redundant ligamentum flava produce marked narrowing of the dural sac. There
is also right neural foraminal senosis with distortion of the exiting right
L3 nerve root. Left neural foramen patent.
L2-3: disc bulge without significant narrowing of the dural sac. neural
foramina patent
L1-2: disc bulge without significant narrowing of the dural sac. neural
foramina patent
Conus: terminates at the L1 level
Upper sacrum: within normal limits
Impression:
1. Multifactorial severe central spinal stenosis and left neural foraminal
stenosis at L4-5 as above
2. Multifactorial severe central spinal stenosis and right neural foraminal
stenosis at L3-4 as above |
A*******s
发帖数: 9638 | 2 如果有neurological deficits， 我会推荐看spine surgeon。
★ 发自iPhone App: ChineseWeb 7.8
【在 s*******y 的大作中提到】
: 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
: 了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
: referring diagnosis: evaluate for herniated disc
: technique: multislice multiweighted, 1.5 Teslah
: comparison: none
: findings:
: alignment: no subluxations, there is lumbar levoscoliosis
: multilevel degenerative loss of dis aignal and height
: vertebral bodies: no compression fractures
: L5-S1: within normal limits
|
s*******y
发帖数: 46535 | 3 她这些MRI诊断上能看出来有neurological deficits么？
老太太年轻的时候是运动员，现在平时也还是生龙活虎的，就是这几年问题比较多
【在 A*******s 的大作中提到】
: 如果有neurological deficits， 我会推荐看spine surgeon。
:
: ★ 发自iPhone App: ChineseWeb 7.8
|
n****r
发帖数: 1568 | 4 没啥大事。随便找个pain management 就好了，他们可以帮你做个神经
传导测试，然后局部封闭注射那个steroid。之后长期物理治疗。 |
s*******y
发帖数: 46535 | 5 这么好啊，哈哈，回头报个喜讯过去
多谢
【在 n****r 的大作中提到】
: 没啥大事。随便找个pain management 就好了，他们可以帮你做个神经
: 传导测试，然后局部封闭注射那个steroid。之后长期物理治疗。
|
A*******s
发帖数: 9638 | 6 Neuro deficits are about her symptoms which you can not tell on MRI, eg,
incontinence, leg weakness and unable to walk.
She has severe lumbar stenosis, surgery intervention could significantly
improve her life quality. Once again, you need to consult her Doctor to make
the decision.
【在 s*******y 的大作中提到】
: 她这些MRI诊断上能看出来有neurological deficits么？
: 老太太年轻的时候是运动员，现在平时也还是生龙活虎的，就是这几年问题比较多
|
s*******y
发帖数: 46535 | 7 多谢各位。大夫她在瞧，就是老太太英文不怎么灵光，我们也不在一个城市，也没法陪
她去看大夫，所以想网上能多少得到些信息对她也是有帮助的
make
【在 A*******s 的大作中提到】
: Neuro deficits are about her symptoms which you can not tell on MRI, eg,
: incontinence, leg weakness and unable to walk.
: She has severe lumbar stenosis, surgery intervention could significantly
: improve her life quality. Once again, you need to consult her Doctor to make
: the decision.
|
s*******y
发帖数: 46535 | 8 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
referring diagnosis: evaluate for herniated disc
technique: multislice multiweighted, 1.5 Teslah
comparison: none
findings:
alignment: no subluxations, there is lumbar levoscoliosis
multilevel degenerative loss of dis aignal and height
vertebral bodies: no compression fractures
L5-S1: within normal limits
L4-5: disc bulge and broad posterior disc protrusion, facet arthrosis and
redundant ligamentum flava produce marked narrowing of the dural sac. There
is also right neural foraminal senosis with distortion of the exiting right
L3 nerve root. Left neural foramen patent.
L2-3: disc bulge without significant narrowing of the dural sac. neural
foramina patent
L1-2: disc bulge without significant narrowing of the dural sac. neural
foramina patent
Conus: terminates at the L1 level
Upper sacrum: within normal limits
Impression:
1. Multifactorial severe central spinal stenosis and left neural foraminal
stenosis at L4-5 as above
2. Multifactorial severe central spinal stenosis and right neural foraminal
stenosis at L3-4 as above |
A*******s
发帖数: 9638 | 9 如果有neurological deficits， 我会推荐看spine surgeon。
★ 发自iPhone App: ChineseWeb 7.8
【在 s*******y 的大作中提到】
: 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
: 了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
: referring diagnosis: evaluate for herniated disc
: technique: multislice multiweighted, 1.5 Teslah
: comparison: none
: findings:
: alignment: no subluxations, there is lumbar levoscoliosis
: multilevel degenerative loss of dis aignal and height
: vertebral bodies: no compression fractures
: L5-S1: within normal limits
|
s*******y
发帖数: 46535 | 10 她这些MRI诊断上能看出来有neurological deficits么？
老太太年轻的时候是运动员，现在平时也还是生龙活虎的，就是这几年问题比较多
【在 A*******s 的大作中提到】
: 如果有neurological deficits， 我会推荐看spine surgeon。
:
: ★ 发自iPhone App: ChineseWeb 7.8
|
|
|
n****r
发帖数: 1568 | 11 没啥大事。随便找个pain management 就好了，他们可以帮你做个神经
传导测试，然后局部封闭注射那个steroid。之后长期物理治疗。 |
s*******y
发帖数: 46535 | 12 这么好啊，哈哈，回头报个喜讯过去
多谢
【在 n****r 的大作中提到】
: 没啥大事。随便找个pain management 就好了，他们可以帮你做个神经
: 传导测试，然后局部封闭注射那个steroid。之后长期物理治疗。
|
A*******s
发帖数: 9638 | 13 Neuro deficits are about her symptoms which you can not tell on MRI, eg,
incontinence, leg weakness and unable to walk.
She has severe lumbar stenosis, surgery intervention could significantly
improve her life quality. Once again, you need to consult her Doctor to make
the decision.
【在 s*******y 的大作中提到】
: 她这些MRI诊断上能看出来有neurological deficits么？
: 老太太年轻的时候是运动员，现在平时也还是生龙活虎的，就是这几年问题比较多
|
s*******y
发帖数: 46535 | 14 多谢各位。大夫她在瞧，就是老太太英文不怎么灵光，我们也不在一个城市，也没法陪
她去看大夫，所以想网上能多少得到些信息对她也是有帮助的
make
【在 A*******s 的大作中提到】
: Neuro deficits are about her symptoms which you can not tell on MRI, eg,
: incontinence, leg weakness and unable to walk.
: She has severe lumbar stenosis, surgery intervention could significantly
: improve her life quality. Once again, you need to consult her Doctor to make
: the decision.
|
a**********0
发帖数: 87 | 15 agree, facet joint injection, or ESI, get an opinion from PMR, if pain is
the main concern.
If there is progressive neurological deficit, you can get a Neurosurg or
spine surg consult, otherwise, the mri did not indicate any need for
referral, usually, referral is needed if myelopathy is evident on MRI, which
is next to impossible in LS issues. Spine surgery in lumbar area is going
out of flavor, most spine orthopods are very conservative now comparing to
10+ years ago.
whatever her symptoms are, PT is the way to go.
Hope she feels better
【在 n****r 的大作中提到】
: 没啥大事。随便找个pain management 就好了，他们可以帮你做个神经
: 传导测试，然后局部封闭注射那个steroid。之后长期物理治疗。
|
s*******y
发帖数: 46535 | 16 多谢，要是有中文就好了，:)
上周她的专科大夫突然说有什么call out，postpone了她的appointment，所以也没有新
的进展，不过我把大家的意见都给她看了
昨天大家一起去打球，老太太还是生龙活虎的，不过可以停下来以后还是可以感觉到她
pg还是腿疼的还是挺厉害的
希望没什么大问题
which
【在 a**********0 的大作中提到】
: agree, facet joint injection, or ESI, get an opinion from PMR, if pain is
: the main concern.
: If there is progressive neurological deficit, you can get a Neurosurg or
: spine surg consult, otherwise, the mri did not indicate any need for
: referral, usually, referral is needed if myelopathy is evident on MRI, which
: is next to impossible in LS issues. Spine surgery in lumbar area is going
: out of flavor, most spine orthopods are very conservative now comparing to
: 10+ years ago.
: whatever her symptoms are, PT is the way to go.
: Hope she feels better
|
