How does my recent MRI report vary from the one taken eight years ago?

Question

Hello doctor,

For the last eight years, I have had numbness in my toe, the one next to the big toe. Now, it slowly spread to just above the knee and in the area above the ankle below the knee on the right leg. There is no sciatic pain on either side. I have had mild diabetes for 10 years. My magnetic resonance imaging (MRI) result eight years ago was as follows: 1. Degenerative disk disorder between L3-L4, L4-L5 and disk prolapse and disk herniation in L5-S1, and mild compression noted in L5-S1. 2. Tarlov cyst at the level of S2. Yesterday's MRI result was as follows: 1. L2-L3, diffuse disk bulge noted, causing anterior thecal sac indentation. 2. L3-L4, diffuse disk bulge noted, causing anterior thecal sac indentation and compromise of bilateral recesses. 3. L4-L5, diffuse disk bulge noted, causing anterior thecal sac indentation and compromise of bilateral recesses. 4. L5-S1, diffuse disk bulge noted, causing anterior thecal sac indentation. Nerve conduction study: Bilateral moderate sural sensory axonal neuropathy in lower limbs.

Answer 1

Hello,

Welcome to icliniq.com. I have read your query, seen the attached pictures (attachment removed to protect patient identity), and understand your concerns about the compression of nerves and diffuse disc prolapse at the lower lumbar region. 1. Although you have not asked about the next line of treatment, considering the progression over the last eight years and your current age, I feel a surgical intervention can be explored. The surgery will ensure there is no further damage to the disc, which will eventually stop the progression of the disease. 2. Since you have had diabetes and hypertension over the last 10 years, it is possible that you may not get clearance for surgery easily. In that case, going for medication is the only option that includes Pregabalin for pain management. In such cases, I often suggest taking 75 mg twice a day to 150 mg twice a day for effective relief from pain. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. 3. In addition to either of the above two options, it is important to undertake physiotherapy. This method of treatment has a significant role. The required exercises must be carried out under the expert guidance of a physiotherapist. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.