Sep 26, · Thecal sac impingement will often lead to painful conditions. The thecal sac is filled with CSF (cerebrospinal fluid), and it covers the spinal cord. Its parts are the inner dura and the outer arachnoid membrane. The thecal sac runs “until the S1 to S3 vertebral levels”. Apr 21, · 3. L1-l2 (4) disc shows assymetric diffuse disc bulge causing anterior thecal sac indentation. (ap canal diameter my) 4.l2- l3 (4) disc shows assymetric diffuse disc bulge causing anterior thecal sac indentation. (ap canal diameter mm) 5.l3-l4 (4) disc shows assymetric diffuse disc bulge causing anterior thecal sac indentation.
Respected doctors. As per mri scan I have the following problems: 1. L1-l2 4 disc shows assymetric diffuse disc bulge causing anterior thecal sac indentation. I think my life is destroyed completely. Zac please give me suggestions. How critical my disc bulge as anferior report?
Anteeior it be rehabilitated? We don't support your browser. Please upgrade your browser or download modern browsers from here! Consult Now. Common Specialities. As per mri scan I have the following p Health Query. Slip Disc. Praneet Singh. Ask Free Question. Thank you for contacting.
Schmorl's nodes and the modic anterjor and degenarated disc can be a cause of pain in your case. Disc bulges per se look insignificant as per the mri report. However anything can be said conclusively only after a thorough clinical examination and proper history. Yes definitely it can be treated. Treatment options under interventional pain management include what is the anterior thecal sac injections, biaculoplasty for disc degeneration.
Please get in touch for a detailed discussion. Was this answer helpful? Thank you antsrior your feedback. Ssac offered by doctors on Lybrate are of advisory nature i. Content posted on, created for, or compiled by Lybrate is not intended or designed to replace your doctor's independent judgment about any symptom, condition, or the appropriateness or risks of a procedure or treatment for a given person.
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Related Lab Tests:. View All. Related questions. I have a bad pain in my knees. Im not able to stand even. I having suffering l4 l5 disc bulge issue.
I am planing to go to jo I how to get rid of hemorrhoids yahoo 25 years. I am suffering from slip disc S4 S5 for more than Hello mam. Mam I am suffering from back pain n slip disc problem fr I am 55 female suffering fron degenerative disc disease due rhe trau Related Health Tips.
Lumbar Degenerative Disc Disease Ayurvedic Management For Slip Disc!
The conus medullaris is the terminal end of the spinal cord.. Gross anatomy. After the cord terminates, the nerve roots descend within the spinal canal as individual rootlets, collectively termed the cauda equina.. The conus medullaris most commonly terminates at the L1/2 intervertebral disc level in children and adults Extending from the conus is a delicate strand of fibrous tissue. The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac. Surgical treatment that includes a laminectomy is the most effective remedy for severe spinal stenosis; however, most cases . results in thecal sac compression; presents with nonspecific root compression or symptoms of lower nerve root (at the L4/5 level, the root of L5 is affected) lateral recess stenosis (subarticular recess) caused by facet joint arthropathy and osteophyte formation. overgrowth of the superior articular facet is usually the primary culprit.
Average 3. The wound is then closed, and no instrumentation or fusion is performed. This procedure would be indicated in which of the following: Tested Concept. Imaging studies are shown in Figure A. Imaging studies are shown in Figure B. Imaging studies are shown in Figure C. Imaging studies are shown in Figure D. Imaging studies are shown in Figure E. Over the past 4 months, he also notes a decreased ability to walk long distances due to pain, which is relieved by sitting down.
Which of the following statements is true regarding this patient's 4-year outcome in regards to surgical and non-surgical management? Tested Concept. Surgical management will lead to more improvement in pain, function, and satisfaction. Surgical management will lead more improvement in function, but less improvement in pain.
Which of the following statements is true regarding the anatomic structure that is contributing most to his pathology? It inserts on the ventral surface of the L5 lamina closer to the inferior edge than the superior edge. It originates from the ventral surface of the L4 lamina closer to the superior edge than the inferior edge.
He denies significant pain radiating distal to his knee and denies any weakness or numbness in his legs. Which of the following components of the history and physical would be most expected in this patient?
Increased pain with combined passive straight elevation of his right leg and dorsiflexion of his ankle. The line from X to Y represents the AP canal diameter. The line from Z to W represents the right-to-left diameter of the canal. The circle represents cross-sectional area of the canal. Which of the following statements would define critical stenosis?
Pain is improved by sitting down and leaning forward. He has attempted physical therapy without improvement in symptoms. A T2-weighted midline sagittal image is shown in Figure A. A flexion and extension lateral radiograph are shown in Figure C and D.
No improvement in symptoms compared to epidural steroid injection ESI at 4 years. Improvement in pain, function and disability compared to nonoperative treatment at 2 years but not 4 years. Improvement in pain, function and disability compared to nonoperative treatment at 2 and 4 years. No improvement in pain, function, and disability compared to nonoperative treatment at 2 and 4 years. His surgery was remarkable for a dural tear that was repaired. He now presents with recurrence of his leg pain and back pain.
Physical exam shows some mild erythema surrounding the incision. What is the most appropriate next step in management? Surgical irrigation and debridement with commencement of antibiotics after cultures are obtained. He denies symptoms with exercise on a stationary bike. Initial treatment including physical therapy, NSAIDS, and an epidural steroid injection provided only temporary relief of his symptoms, which have returned and are now severe.
On physical exam he has normal motor strength in his lower extremities, negative straight-leg raise tests bilaterally, and palpable bilateral dorsalis pedis pulses. Lumbar flexion-extension radiographs show no spondylolisthesis or instability. A decompressive laminectomy with bilateral medial facetectomies and foraminotomies. A decompressive laminectomy, bilateral medial facetectomies and foraminotomies, and an instrumented fusion. His pain is worse with prolonged standing and improves with sitting.
His symptoms have progressed to the point that it is now difficult for him to walk to the mailbox. Four months of physical therapy and a series of epidural corticosteroid injections failed to improve his symptoms.
Figure A and B are an AP and lateral lumbar spine radiograph. What is the most appropriate next step in treatment? Preoperative flexion and extension radiographs of the lumbar spine are shown in Figure A.
Following surgery she reports no significant improvement in her right leg pain. What is the most likely cause of her residual leg pain. A water-tight repair is subsequently performed. How will this affect postoperative care and ultimate clinical outcomes? A hemilaminectomy was performed to obtain adequate visualization of the defect, and primary repair of the tear was performed. One month postoperatively he returns to the office complaining of severe headaches and occasional nausea which is worse with standing.
He denies fever or chills. On physical exam his wound is well healed with no cellulitis or erythema. What is the most likely diagnosis?
You plan on proceeding with lumbar decompression. What is the most powerful preoperative prognostic factor for clinical outcomes with surgical treatment of this condition. Lumbar Spinal Stenosis. Leah Ahn. Derek W. Please rate topic. Technique Guide. Orthobullets Team. Upgrade to PEAK. L 2 Question Complexity. Question Importance. Tested Concept QID: L 3 Question Complexity.
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Nick Shamie. Listen Now min. Team Orthobullets 4. Lumbar Stenosis C Please login to add comment. Cancel Save. Important to differentiate symptoms of neurogenic claudication from vascular claudication flexion improves symptoms in neurogenic claudication because this posture increases the limited area available for the neural elements in the spinal canal and foramen ff.
Neurogenic Claudication. Vascular Claudication. Postural changes. Walking upright. Causes symptoms. Standing stationary. Relieves symptoms. Stair climbing. Up easier back flexed. Down easier back extended. Stationary bicycle back flexed.
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