What Does "Lumbar Spondylosis With Tiny L3/L4 Herniation With Potential For Dural Irritation" Mean?

Posted on Sat, 28 Dec 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 28 Dec 2013 Answered on

Fri, 17 Jan 2014 Last reviewed on

Question : Hello I would like help understanding MRI result Findings, The conus lies at L1.Cord signal and morphology are unremarkable m There is mild multilevel lumbar discal degeneration , The lumbar pars are intact . L3/L4 Mild diffuse disc bulge , with small posterior protrusion mildly indenting the thecal sac ,Mild facet hypertrophy . Disc and ligamentum flavum touch the left descending L4 root .No central stenosis ,No foraminal stenosis L4/L5 Mild diffuse disc bulge , no stenosis , no neural compromise L5/S1, Mild bilateral facet hypertrophy . No stenosis Conclusion : Lumbar spondylosis , with tiny L3/L4 herniation with potential for Dural Irritation , and possible Irritation of the left L4 root

Answered by Dr. Jorge Brenes-Salazar (3 hours later)

Brief Answer: Simple explanation below Detailed Answer: Hi, Greetings. Let me explain the results in a simple way: There are degenerative changes in your spine, related most likely to your osteoporosis and arthritis, "wear and tear" changes. The most remarkable are in the lumbar spine (lower backbone) at the 3rd and 4th bones from that level. They involve some little bone spurs, with tiny, as they say in the report, tiny protrusion of the disc between those bones. There are discs, or small "rubber like bands" between the bones that act as cushions. As we age they become smudged and extend outside their limits, just like a big beef XXXXXXX in a burger with a small sized bread. They can cause some compression of the spine or the nerves that originate from the spine to the sides, like branches of a tree. If you have had some pains, or abnormal sensations on your left back or left leg, it could be due to that discrete compression. Wish you the very best, Dr Brenes-Salazar MD Mayo Clinic MN

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Jorge Brenes-Salazar (1 hour later)

I still dont understand what this means and dont think you have described this fully to me ((L3/L4 Mild diffuse disc bulge , mildly indenting the thecal sac)) ?What does mildly indenting the thecal sac )) and (( Disc and ligamentum flavum touch the left descending L4 root .mean)) could you be more specific , many thanks

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

Brief Answer: A picture is worth a thousand words Detailed Answer: Dear XXXX, Many of my Anatomy teachers said that explaining anatomy without a visual aid is like singing without vocalizing... hard or almost impossible. Please open in your browser this link and refer to it for the explanation: WWW.WWWW.WW au/injuries-conditions-1/bulging_disc The drawing is a cross section, like cutting an XXXXXXX and looking from above at the lumbar level. You can see that a normal disc is like a cushion; when it is degenerated like in your case, the inner nucleous (material is like jello) protrudes backwards and compresses either the spine, covered by a thin layer called the thecal sac (you can see that the spine, pictured in yellow in the drawing is covered by a layer), and it can also protrude laterally just like in the drawing, and compress the nerve root, as you can clearly see in the picture as well; the ligamentum flavum is a yellowish layer on the back of the spine, not clearly depicted here, but together with that "jello material" they are impinging on the initial portion of that L4 nerve. Again, unless you refer to the drawing, it will probably be quite difficult to understand just with words. Hope this helps Yours truly

Above answer was peer-reviewed by : Dr. Raju A.T