|
Message Board>
Lumbar MRI
bjones
6 posts
Mar 19, 2009
6:39 AM
|
Had a guy here, 77 y/o. He happened to bring in his lumbar MRI results:
1. L1 – L2: Mild fact hypertrophy, ligamentum flavum redundancy, and small disc bulge. No significant disc herniation, spinal stenosis, or foraminal narrowing.
2. L2 – L3: Mild fact hypertrophy, ligamentum flavum redundancy, and broad based disc bulge. No significant disc herniation, spinal stenosis, or foraminal narrowing.
3. L3 – L4: Facet hypertrophy, ligamentum flavum redundancy, and broad based disc bulge with left sided protrusion cause moderate spinal stenosis with left worse than right subarticular zone narrowing likely impacting the descending left L4 nerve root. Left worse than right foraminal narrowing may also impact the exiting left L3 nerve root.
4. L4 – L5: Facet hypertrophy, ligamentum flavum redundancy, and broad based disc bulge cause mild spinal stenosis with mild subarticular zone narrowing. Foraminal narrowing is also mild without definite nerve root compression.
5. L5 – S1: Mild facet hypertrophy, ligamentum flavum redundancy, and small disc bulge without significant disc herniation or spinal stenosis. Bilateral foraminal narrowing is mild to moderate, possibly impacting the exiting nerve roots.
What do you do??
|
DthuePT
8 posts
Mar 19, 2009
6:39 PM
|
first I will start with a question. how would you treat him if you did not have an MRI? I see lots of LBP pts, I like to incorporate TMR elements and traction if pt has radicular pain. one thing I have also found helpful in lumbar pain is the side bend L/R go to good side. sometimes I put them over a bosu ball (swiss ball with flat bottom) with an overpressure to "pull" hips away from shoulders 30 sec. or so to good side. hope this helps
|
Mickey
13 posts
Mar 22, 2009
8:33 PM
|
It's nice to have the MRI info, but the real info you need is what does the body want to do! Don't let the MRI give you pre-conceived notions about the patient. Get the pt moving in whatever position is comfortable. Let the pt determine, through motion, what they can and can't do and then proceed from there. I would also find out if they have a position of comfort they like to use and see if they can make it more comfortable. Their body will speak, loudly, if you will allow it. Keep in mind that they have probably been told "Don't do this, or don't do that" which has most likely resulted in even more loss of motion throughout the body, further compounding their issues.
|
bjones
7 posts
Mar 23, 2009
12:47 PM
|
Good answers! Tom actually emailed me with "Twists and arm raises" cause that is usually what I do. And if the guy had issues Tom would be correct! Check out the mini-case studies...
This was really just kind of a "thought" type of post...you see the guy has absolutely no pain/ROM issues. Essentially just "gray hair of the insides" is what we call it. So the "real" answer to the question is: Nothing.
There are just way too many therapists that I run into that just "hang onto" scan/testing results. It doesn't mean they are bad (actually some are) but they just haven't had enough education, mentoring, "out of the box" thinking...or their box is just too small.
Thanks for playing and knowing!!
bill
|
jen
38 posts
Apr 02, 2009
5:40 PM
|
and you put in alll that effort to type out all that super detailed stuff! trickster huh? small boxes and paranoia-but if it feels good and moves good (and is legal and dont hurt nobody) how can it be that bad?
|
|
|
|
