b*******l
发帖数: 1095 | 1 【 以下文字转载自 Medicine 讨论区 】
发信人: byrnehell (乐天), 信区: Medicine
标 题: 椎间盘突出， 诚心求教医疗建议， 付MR检验结果
发信站: BBS 未名空间站 (Sat Feb 18 00:38:58 2012, 美东)
患者女， 年约60， MR 诊断后已接受大概俗称的“打封闭”治疗，但腰部仍然感觉痛
楚，患者自我评价“打封闭" 的疗效（好转情况）大约是100%中的30%。医生建议进行
外科脊椎手术。 考虑患者年纪及病程，诚心求建议。
EXAM: MR LUMBAR SPINE WITHOUT CONTRAST
INDICATION: Chronic low back pain with left lower extremity radiculopathy.
Weak left sided reflexes. Herniated nucleus pulposus. Technique: Sagittal
and axial T1 and fast spin echo T2, sagittal STIR sequences are performed.
Findings:
There is lower lumbar dextroscoliosis. Very fractional anterolisthesis of L4
is appreciated thought to be secondary to observed inferior facet
arthropathy consistent with mild degenerative spondylolisthesis. No
spondylolysis is identified. Modic type 2 and Modic type3 alteration in
marrow signal is seen at the L4-5 level. No bone marrow replacement process
is seen. No compression deformity is noted. The conus medullaris is situated
at the Li level and appears intact.
At L1-2, the central canal and neural foramina are not compromised.
At L2-3. Mild diffuse disc bulge is seen with patency of the central canal
and neural foramina.
At L3-4, there is diffuse disc bulge with hypertrophic ligamentum flavum
with patency of the central canal. The neural foramina appear to be patent.
At L4-5, there is mild diffuse disc bulge eccentrically prominent on the
left side. Hypertrophic ligamentum flavum and facet arthropathy is present.
The central canal appears maintained. The neural foramina do not appear to
be compromised with some disc material bulging into the left neural foramen.
At L5-S1 , there is diffuse disc bulge with patency of the central canal.
The neural foramina demonstrate mild narrowing on the right from bone
spurring and disc bulging extending laterally and patency on the left.
CONCLUSION::
There is lumbar spondylosis with lower lumbar dextroscoliosis. Mild grade 1
degenerative spondylolisthesis of L4 is seen.
Inferior facet arthropathy is noted.
Multilevel disc bulging is seen without compromise of the central canal. No
focal disc herniation is seen.
Mild narrowing of the right neural foramen at L5-s1 present from bone
spurring and disc hulging extending laterally. No significant neural
foraminal compromise is observed.
万分感谢各方面意见！ |
A*******s
发帖数: 9638 | 2 上个片子看看？
【在 b*******l 的大作中提到】
: 【 以下文字转载自 Medicine 讨论区 】
: 发信人: byrnehell (乐天), 信区: Medicine
: 标 题: 椎间盘突出， 诚心求教医疗建议， 付MR检验结果
: 发信站: BBS 未名空间站 (Sat Feb 18 00:38:58 2012, 美东)
: 患者女， 年约60， MR 诊断后已接受大概俗称的“打封闭”治疗，但腰部仍然感觉痛
: 楚，患者自我评价“打封闭" 的疗效（好转情况）大约是100%中的30%。医生建议进行
: 外科脊椎手术。 考虑患者年纪及病程，诚心求建议。
: EXAM: MR LUMBAR SPINE WITHOUT CONTRAST
: INDICATION: Chronic low back pain with left lower extremity radiculopathy.
: Weak left sided reflexes. Herniated nucleus pulposus. Technique: Sagittal
|
R*******t
发帖数: 367 | 3 It really doesn't sound too bad, except for "with some disc material bulging
into the left neural foramen." of L4-5 on the left. There is not even disc
herniation mentioned. |
A*******s
发帖数: 9638 | 4 I agree, but still like to take a look at the films.
bulging
disc
【在 R*******t 的大作中提到】
: It really doesn't sound too bad, except for "with some disc material bulging
: into the left neural foramen." of L4-5 on the left. There is not even disc
: herniation mentioned.
|
R*******t
发帖数: 367 | 5 We better ask for the entire study, :p, or at least 3 sagittal and 3 axial
images for each intervertebral space level in t1 t2 and stir sequences.
【在 A*******s 的大作中提到】
: I agree, but still like to take a look at the films.
:
: bulging
: disc
|
A*******s
发帖数: 9638 | 6 lol
【在 R*******t 的大作中提到】
: We better ask for the entire study, :p, or at least 3 sagittal and 3 axial
: images for each intervertebral space level in t1 t2 and stir sequences.
|
b*******l
发帖数: 1095 | 7 感谢两位的回复，患者自己的感觉就是脚有点麻，腰有点痛，例如如果坐在地上的小板
凳上，十分钟就会觉得腰很痛，睡觉时如果姿势不“正确”腿就会麻。
我想问各位，如果进行外科手术的话，风险高不高和会不会有后遗症。患者自己也倾向
不接受手术。患者想在见外科医生前自己心里有个底。
我也很想上个片，但我的两个扫描仪都扫不了这么大的篇幅，我会尽量再想办法。
感谢各位回复 |
A*******s
发帖数: 9638 | 8 Get a CD from the MRI center. Very simple.
【在 b*******l 的大作中提到】
: 感谢两位的回复，患者自己的感觉就是脚有点麻，腰有点痛，例如如果坐在地上的小板
: 凳上，十分钟就会觉得腰很痛，睡觉时如果姿势不“正确”腿就会麻。
: 我想问各位，如果进行外科手术的话，风险高不高和会不会有后遗症。患者自己也倾向
: 不接受手术。患者想在见外科医生前自己心里有个底。
: 我也很想上个片，但我的两个扫描仪都扫不了这么大的篇幅，我会尽量再想办法。
: 感谢各位回复
|
