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At L4-L5diffuse disc bulge with right para central protrusion causing severe canal stenosis, compression over the allows sac, nerve root of audacity equine, bilateral traversing nerve roots in lateral recess marked on right side. AtL5-S1 a focal posterior central disc bulge with tear, mild to moderate canal stenosis, compression over the alloy sac, left traversing S1 nerve root in lateral recess. Neural foramina on either side however exiting nerve root look free in neural foramen. Hip n screening within normal limits. This is the report of MRI. please suggest.
Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.
Reversal of cervical lordosis explained
The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.
When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.
Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.
In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.
Reversal of cervical lordosis causes
The spinal curvature in the neck is constantly in flux to some degree.
Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:
Scoliosis can affect the normal lordotic curvature in the neck.
Cervical spondylolisthesis is a major source of reversed lordotic curvature.
Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.
Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.
Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.
Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.
Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.
Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.
In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.
Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.
While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.
The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post head injury
Poor sitting/working postures
Congenital spinal curvatures
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine
Anatomy: straight vs. Curved
I've always heard that it was good to stand up straight.
stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.
Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.
When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.
Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.
In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.
Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:
Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.
Sir my mom suffering from pain in almost all of the body specially in the backside, headache is there and also some sort of problem in breathing. Her protein is 9.8,albumin is 3.0,globulin 6.8,crp, alp,creatinine, vit D all are normal. Her MRI report says "study revels central & bilateral paracentral disc herniations with annular tear at L4-L5 and L5-S1 levels with thecal compression & bilateral traversing nerve root impingement. Mild retrolisthesis of L4 over L5 vertebral body is noted. There are degenerative osteophytes & disc desiccation as described in the text. Sir please tell me how can I treated her, doctor advice her tab maxgalin and accuvin what is the problems she can relief or not or any serious concern. Please help Sir.
Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.
Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.
Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.
- A lump in either of the breasts or armpits
- Change in size, shape, or contour of either breast
- Redness of your breast or nipple
- Discharge of clear or bloody fluid
- Thickening of breast tissue or skin that lasts through a period
- Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
- One area on the breast that looks very different from the other areas
- Hardened area under the breast skin
Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.
Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.
- Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
- Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
- Age: Women over 50 are at higher risk of developing breast cancer.
- Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
- Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
- Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
- Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.
Stages: Starting from stage 0, higher stages indicate advanced disease.
- Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
- Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
- Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
- Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
- Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.
Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.
- Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
- In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
- Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
- Ultrasound screening can also be given in addition to mammograms.
- Breast MRI is another way to screen for breast cancer if the risk is greater.
Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.
- Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
- Tamoxifen is used in women who are at high risk for breast cancer.
- Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
- In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).
Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.
Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.
Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:
- Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
- Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
- Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.
In case you have a concern or query you can always consult an expert & get answers to your questions!
As per my MRI report for lumber spine, disc protrusion seen at L5-S1 indenting anterior thecal sac and narrowing left neural recess. Disc hydration is Los at L5-S1. I have severe lower back pain for last one month. What is the ideal plan for treatment?
My mother is on ventilator now she has stage 4 breast cancer and she is unable to breathe she is uncouysus now please give me suggestion.
The very term 'breast cancer' can send shivers down a woman's spine. The associated pain, agony, sufferings are enough to deter a person. The effectiveness of the treatment depends on the stage in which the condition is detected. Unfortunately, many women neglect and overlook the early signs, thereby delaying the treatment.
Self-awareness is vital for prevention, early detection and treatment of breast cancer. Treatment and prevention can only work when a person is alert and agile. If you notice any unusual symptoms, waste no time and consult an experienced physician at the earliest. However, prevention is always better than a cure. A few healthy habits, if practiced diligently, can go a long way to prevent and reduce the incidences of breast cancer.
- A healthy body weight: Overweight and obese women are at a greater risk of suffering from breast cancer. The key to this problem is as simple as shedding off the extra kilos. Research suggests that incidences of breast cancer are slightly lower in women who maintain body weight within healthy limits. Enrich your diet with fruits and vegetables. Drink water and other healthy fluids (coconut water, fresh fruit juice,) at regular intervals.
- Breastfeed for a healthy breast: Breastfeeding is important for the health of both the baby and the mother. While babies get the necessary nourishment, women who are into breastfeeding are less likely to suffer from breast cancer. Thus, all healthy lactating mothers should breastfeed their babies.
- Keep the vices at bay: Severe smoking and alcohol consumption can harm your body beyond imagination, with breast cancer being one the many harmful side effects. Drinking within limits (1 drink or even less per day) is still acceptable, but anything in excess is sure to spell doom.
- Some of the imaging and diagnostic tests can be harmful to your body: Repeated exposure to the radiations from CT-scan can put a woman at an increased risk of developing breast cancer. Limiting the exposure to such radiations may help to check the incidences of breast cancer.
- Physically active and agile: Lack of physical exercise and an unhealthy lifestyle can wreak havoc with health complications as serious as breast cancer. It is important to keep your body physically active. Light to moderate exercise (for 30 minutes), jogging, cycling, swimming and other physical activities can work wonders for your body. Avoid stress and anxiety. Proper rest and a sound sleep are equally important.
Various research and studies suggest that women who are into hormone therapy are more susceptible to breast cancer. Such patients are often advised to avoid and replace hormone therapy with alternative treatments. However under extreme conditions (where the alternative treatments fail to produce the desired result), limiting the duration as well as the dosage of the hormone therapy may be helpful. If you wish to discuss about any specific problem, you can consult an Oncologist.