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Osteophytes and Retrolisthesis

I am from Jamshedpur (Jharkhand State), INDIA. My brother, 60 years old, was suffering from back pain for some time. Recently high resolution MR scanning of Lumbo-Sacral Spine was performed on 1.5 Tesla MR Scanner to obtain T1 TSE and T2 TSE sequences, found to be in the sagittal and axial planes. STIR long TE sequence in the coronal plane. The study revealed mild loss of normal lumbur lordic curvature. Mild marginal osteophytes & early disc desiccation are seen at multiple levels. Grade I Retrolisthesis, reduction of disc height with modic type II plate change is seen at L5-S1. The vertebral bodies otherwise appear normal in height. Diffuse disc bulge with central & paracentral extrusion is seen at L5-S1. compressing ventral thecal sac causing narrowing of bilateral exit foramina & compression of bilateral traversing & exiting nerve roots. Diffuse disc bulge and right paracentral protrusion is seen at L4-5 indenting ventral thecal sac causing narrowing of bilateral exit foramina & compression of right exiting nerve roots. Other intervertebral discs show no significant disc bulge or herniation. The facet joints & ligamentum flavum appear unremarkable. The discal cord and conus medullaris appear normal. Thecal sac shows normal CSF signals.
IMPRESSION: MR study reveals degenerative spondilitic changes with diffuse disc bulge with central & paracentral extrusion at L5-S1, compressing ventral thecal sac causing narrowing of bilateral exist foramina & compression of bilateral traversing & exiting nerve roots, AND diffuse disc bulge and right paracentral protrusion at L4-5 indenting ventral thecal sac causing narrowing of bilateral exit foramina & compression of right exiting nerve roots.
We would be grateful if any expert on the subject offer valuable advice on the further course of treatment whether surgical or non-sugical as we are totally confused with clear two schools of thoughts among the local doctors for future treatment which is burdened with our very limited financial capabilities.
Thanks and best regards to all readers,
Jayanta Ray,
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