MRI Lumbar Spine
L: There is a posterior intervertebral disc bulge in the lumbar spine at the level of L3–4. The lumbar spine does show some other degenerative changes along with other disc bulges. I have especially focused on the L3–4 disc bulge because it is most readily seen demonstrating canal stenosis.
CAT: The disc is bulging posteriorly into the spinal cord causing stenosis of the spinal cord.
CSB: The consistency of the disc bulge is homogeneous. It has a regular shape, which is small and partially rounded. The borders are well defined, pouching out into the spinal canal.
DC: The spine is an intricate set of bones, muscles, nerves, and discs. The lumbar spine is made up of the last five vertebrae of the spine. The vertebrae are the bones of the spine. Their function is to provide support and protection of the spinal cord. The intervertebral discs are fibrocartilaginous discs that serve as cushions or shock absorbers located between the vertebral bodies. The disc is made up of two parts. The annulus fibrosis is the outer layer of the disc and is made up of fibrocartilage laid down by layers to give the disc strength. The inner part of the disc is made up of a gel-like substance called the nucleus pulposus, which is made up of mostly water and protein.
A disc bulge is the disruption of the normal integrity of the intervertebral disc. Disc bulges are most commonly attributed to gradual abuse or wear and tear causing some of the rings of the annulus fibrosis to break. This allows the liquid center (nucleus pulpous) to eventually push the outer rings, causing it to bulge.
C: This patient was a 76-year-old woman having an MRI of the lumbar spine for back pain. I did not have a medical history on this patient, and there was no known trauma. Based on her age and the radiology report, my best guess as to her disc bulge would be due to degenerative lumbar disc disease.
Degenerative disc disease refers to a syndrome in which painful discs cause chronic low back pain due to change in the structure of the normal disc. Lumbar disc disease occurs in the lumbar area of the spine. Lumbar disc disease is a herniated, ruptured, or bulging disc. As we age, the intervertebral disc may lose water and become dried out. As this happens, the height of the disc becomes shorter. This may lead to deterioration of the tough outer rings allowing the nucleus, or the inside of the rings, to bulge out. This is considered a bulging disc. Degenerative lumbar disc disease is a clinical syndrome characterized by changes of disc degeneration and symptoms thought to be related to those changes.
Symptoms may include back pain and muscle spasms. Pain, numbness, and tingling may also travel down the legs and into feet. Most disc problems get better with time, rest, and proper treatment. Depending on the severity, disc bulges may or may not need surgery.