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Loss of normal lumbar lordosis seen? Due to muscle spasm. Lumbar vertebrae appears normal in alignment .No listhesis. Small Schmorl's nodes noted involving the endplates of multiple lumbar vertebra. Degeneration ofL1-L2, L2-L3 and L4-L5 lumbar intervertebral discPosterior annular tear noted at L1-L2, L2-L3 and L4-LSlevels. At Ll-L2 level there is right paramidline protrusion, No foramina narrowing. At L2-L3, L3-L4 diffuse posterior disc bulge noted ,causing effacement of ventral thecal sac and inferior recess of bilateral neural foramina narrowing at L3-L4 level. At L4-L5 level, posterocentral and left forminal protrusion causing, significant canal stenosis and left neural foramina narrowing ,resulting in compression of exiting L4 and traversing LS nerve roots at this level. At LS-Sllevel, no disc bulge or herniation. Conus medullaris appear unremarkable. Impression:- Lumbar spondylosis degenerative changes as mentioned ,predominant at L4-L5 level.- At L4-LSlevel, posterocentral and left forminal protrusion causing, significant canal stenosis and left neural foramina narrowing ,resulting in compression of exiting left L4 and traversing Left LSnerve roots at this level. I have pain on back due to above isse.
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If pain is confined to back and not radiating to lower limbs and backache tolerable or responsive to pain medication and muscles relaxants, wearing of spinal brace in daytime and physiotherapy exercises if permissible, nothing more needs to be done. If symptoms disrupting normal life activity, a neurologist surgeon or spine surgeon consultation for surgical interference for canal stenoses, foramina narrowing and disc herniation can be decided. So consult spine surgeon.
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