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What is central protrusion indenting the thecal sac and abutting bilateral nerve root

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Old 01-29-2003, 01:29 PM   #1
Join Date: Jan 2003
Location: Wi. USA
Posts: 53
curvil HB User
Question What is central protrusion indenting the thecal sac and abutting bilateral nerve root

Hi all
Well let me fill you guys in, my pain mangement dr. sent me back to work yesterday, started be out @ 4 hrs. a day 5 days in a row, mind you I havent been back to work in over a year, let me tell you PAIN, PAIN PAIN,FROWN
i HAD A MYELOGRAM DONE A COUPLE WEEKS BACK AND DR. SAID EERYTHING LOOKED FINE, (THIS IS A COMP. CASE) mY ATTORNEY SAID THAT COMP MOST LIKELY GOT TO THE PAIN DOC AND HE BUCKLED. ANYWAY, MY ATTORNEY WANTED THE PAIN DOC CLINICAL NOTES AND (sorry I dident know I had the cap lock on) and he sent me back to work before he did any follow up visit. (Ihad seen him 2 weeks ago with such severe pain I thought I would die and nerve pain, doc said meyolgram showed nothing, everything was fine (last time I take his advice on anything) so on the clinical notes he has "lumbar myelogram revealed only partial filling on the right S1 nerve root on the myelogram part and on the CT part there was moderate central protrusion that was indenting the thecal sac and abutting bilateral nerve roots at the L4-5 level causing moderate spinal stenosis at that level. At the L5-S1 level, there was increased filling at the right S1 nerve root sleeve but there was still aome asymmetry between the right and the left.
So what does this mean?
It's all greek to me
sny interpertaion will be greatly appriciated, thanks so much :love1:
laminectomy 1999
discectomy 2001
spinal fusion L5S1 2002
partial hardware removal
chronic back pain
failed back syndrome
right leg and foot numbness, loss of sensation, burning pain

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Old 01-30-2003, 05:51 PM   #2
Join Date: Jan 2003
Location: West Virginia, USA
Posts: 60
kvanrijn HB User


I'm sorry I can't help; it's all greek to me also. But I hope someone comes along that can answer your question.

And I'm really sorry you're in such pain.

God Bless.
Severe pain lower back & left leg/foot beginning 5/2002
Numbness & loss of some movement in left foot 5/2002
MRI 8/2002 results:
DDD with annular tears at L4-5 and L5-S1.
Large left paramedian disc extrusion at L5-S1 which results in mass effect on left S1 nerve root and left side of thecal sac.

Old 01-30-2003, 06:58 PM   #3
Join Date: Dec 2000
Location: New York, USA
Posts: 1,703

Hi Shedevil,

Sorry, I have no clue either, but have you ever had a discogram done ?

In my opinion, this is the best diagnostic test to have done, especially if you know there is something more to your pain, that the docs are not picking up on.

I was amazed at the images that were picked up on mine, compared to what the other tests had found, such as MRI's and Cat Scans.

My doctors have always told me that the discogram was better than the myleogram.

I hope this helps, as it's only my honest opinion.

Also, for some reason, your images are not showing up on your posting, I just wanted to mention that.

Please don't give up [img][/img]

Take care,
Baxter [img][/img]

Two level laminectomy fusion L5-S1 & L2-3 done on 12/6/02.
Fifteen inch scar from the very top of butt crack (sorry), to the bra line.
BAK cages, rods & screws.(Titanium)
My pelvic bone was used for grafting.
Praying that the other two discs in between, won't have to be fused later, as I was told it was a possibility, due to the other two discs in between, not being in that great of shape.
Doc didn't want to fuse four levels, unless it is really necessary.
I would hate to repeat the surgery, as the recovery period, is so very painful.
I also have a free fragment in my T11-12 area, that I'm still refusing surgery for, at this point in time.
That surgery is way too dangerous for me to consider, until if affects my being able to walk.

Old 01-30-2003, 09:16 PM   #4
Senior Veteran
Join Date: Oct 2002
Location: San Francisco Bay Area, CA, USA
Posts: 548
Telzey HB User

Hi shedevil
Sorry to hear you're in such pain. Well, I don't have any medical training, but I've been living with back pain so long sometimes I think I know more than I never wanted about backs!

The "thecal sac" is the spinal cord and its surrounding fluid. The "moderate central protrusion indenting the thecal sac" means that the CT scan shows a bulge in the disk that's centrally located (not on the right or left side) and is pushing into the thecal sac and probably pressing into your spinal cord. That is probably the source of much of your pain. It is "abutting" or touching both sides of the nerve root ("bilateral" = both sides) at L4-L5, or between the 4th and 5th lumbar vertebrae. "Spinal stenosis" is a narrowing of the spinal cord, just repeating what it said earlier.

So in other words, your L4-L5 disk is herniated and bulging and is sticking out into your spinal cord and pressing on the nerve root. YEOWWWWW that must hurt!

Hope this helps.

Good luck with the obnoxious doctors. Don't give up!!

[img][/img] Telzey

4 years of back pain
Annular tear L5-S1 diagnosed 3/02 via MRI
IDET 12/2/02
Still worse pain than pre-op, am told to wait 3-6 months for improvement

[This message has been edited by Telzey (edited 01-31-2003).]

[This message has been edited by Telzey (edited 01-31-2003).]
4 years of back pain, but was still able to work and maintain moderate activity (hiking, low-impact aerobic exercise)
Annular tear L5-S1 diagnosed 5/02 via MRI
IDET 12/2/02
1/26/03 Posterior disc prolapse occurs after sitting too long after walking. Causes new pain down left leg.
3/1/03 Leg pain reduced with exercises from the book "Treat Your Own Back" by Robin McKenzie.
3/9/03 Severe, new buttock and thigh pain and numbness starts.
3/25/03 Used McKenzie techniques to treat buttock and thigh pain -- pain reduced
4/4/03 Started physical therapy
5/8/03 Still worse than pre-IDET, but showing slow improvement with PT, McKenzie exercises, yoga, and Hanna Somatics exercises
5/30/03 PT suggests buttock and thigh pain may be from facet joint
7/6/03 Still worse than pre-IDET due to leg and thigh pain and numbness, and have become so inactive I can't tell whether back pain is better. Can't stand for any length of time, can't walk long, run at all, or do any aerobic activity. I regret agreeing to the IDET and wish I had had more patience with the natural healing process of my disc!

Old 01-31-2003, 12:22 PM   #5
Join Date: Jan 2003
Location: Wi. USA
Posts: 53
curvil HB User

Hi Baxter and Telsey,
Thank you guys so much for the best advice and meaning to my question, I really get so much more info here on this site than from any Dr.'s I have gone to thus far. Thank You AGAIN. I rteally swear you guys and successtory sure are advocates and you should open your own web page I know I have given this sites address to everyone I know with back pain. We here are so lucky to have such informative people on this site.
I am going to print out the papge that explains what I have, My neuro told me everything was fine and looks ok on the meyolgram Why wouldent he tell me whats going on? You know, my husband said that although I take pride in my Dr. Maybe he is covering something up and something went a little wrong when I had the fusion, because I only had mild nerve symptoms (such as tingleing, numbness) before surgery but when I woke up ( a year already) from the fusion this is what I am and still today, absoultly no feeling from knee down, cannot feel when my foot touches the ground, leg swelling, it swells everyday if I am on my feet more than 5 minutes, this is no lie. It sweels to be the sixe triple than the left. and let me tell you I am sooo very embarresed espically in the summer wearing shorts, plus my leg and foot get so hot inside and yet ice cold to touch, I have never been the same. I had a few developments since comp. bought out my pain med dr. I will be posting a new topic when I get home from the pharmacy tonight, watch for my posting and please let me know what you think. THANKS AGAIN, what would I do without all you guys, love ya buches [img][/img]

laminectomy 1999
discectomy 2001
spinal fusion L5S1 2002
partial hardware removal
laminectomy 1999
discectomy 2001
spinal fusion L5S1 2002
partial hardware removal
chronic back pain
failed back syndrome
right leg and foot numbness, loss of sensation, burning pain

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