Postovani Dr Vukasinovicu! U septembru i oktobru 2007 snimio sam prvo donji deo kicme, a onda i celu kicmu i evo tih izvestaja (doduse na engleskom, nadam se da cete ih razumeti): History: Low back pain radiating to right leg. CT SCAN OF THE LUMBAR SPINE: Technique: Axial and sagittal reformats. Segmentation is assumed to be normal with the lumbosacral disc taken to L5/S1. Findings: At L2/L3 , there is a broad based central left paracentral and intraforaminal disc protrusion. There are hypertrophic degenerative changes in the facet joints and ligamentum. There is mild canal narrowing. The nerve roots exit normally. At L3/L4, there is a broad based right paracentral intraforaminal and extraforaminal disc protrusion which in conjunction with hypertrophic degenerative facet joints is associated with right lateral recess and mild foraminal narrowing. At L4/L5, there are marginal end plate osteophytes and hypertrophic degenerative changes in the facet joints and ligamentum. The canal and lateral recesses are of relatively normal dimensions. There is right sided foraminal narrowing involving the exiting L4 nerve root. At L5/S1, there is a shallow left paracentral disc protrusion. There is mild effacement of S1 nerve root in the left lateral recess at its origin, the canal is of normal dimensions. There is bilateral foraminal narrowing due to hypertrophic changes in the facet joints, this is worse on the left than the right. On the sagittal reconstructions, there is noted to be a crush fracture of the body of the L4 which is reduced in height centrally by 50%. This has a chronic appearance. COMMENT: 1. ADVANCED SPONDYLOTIC CHANGE WITH MULTILEVEL FACET JOINT OSTEO-ARTHROSIS, DEGENERATIVE DISC AND END PLATE DISEASE. 2. RIGHT PARACENTRAL, INTRA AND EXTRAFORAMINAL DISC PROTRUSION AT L3/L4 ASSOCIATED WITH LATERAL RECESS NARROWING AND INVOLVING THE ORIGIN OF THE RIGHT L4 NERVE ROOT. THERE IS VERY MILD RIGHT L3 FORAMINAL NARROWING. 3. MARGINAL END PLATE OSTEOPHYTES AND HYPERTROPHIC CHANGES IN THE FACET JOINTS PRODUCING MILD LATERAL RECESS NARROWING, MORE SO ON THE RIGHT THAN THE LEFT AT L4/5 WITH SIGNIFICANT RIGHT SIDED FORAMINAL NARROWING DUE TO MARGINAL END PLATE OSTEOPHYTES INVOLVING THE EXITING RIGHT L4 NERVE ROOT, THIS MAY BE THE SYMPTOMATIC LESION. 4. LEFT SIDED FORAMINAL NARROWING AT L5/S1 DUE TO FORAMINAL OSTEOPHYTES. 5. PROBABLY OLD COMPRESSION INJURY OF THE BODY OF L4. Clinical Details: Neck and brain pain. Crush fracture L4 - ?? osteoporosis. CERVICAL SPINE X – RAY Findings: There are marginal osteophytes at the C5/6 level. The vertebral bodies are normal in height and alignment. The facets joints are normally aligned. There is no significant foraminal stenosis. There were no cervical ribs and no destructive apical lung or bone lesions. THORACIC SPINE X – RAY Findings: There are marginal osteophytes at multiple levels. There is wedging of one of the mid dorsal vertebra measuring almost 30 – 40% in severity. The posterior elements and end plates are intact with no paraspinal soft tissue masses. COMMENT: COMPRESSION FRACTURE MID DORSAL SPINE. LUMBAR SPINE X – RAY Findings: There is a compression fracture of the body of L4 reduced in height by approximately 20%. There are marginal osteophytes at this level in keeping with spondylotic change and degenerative change in the L5/S1 disc. There are no anterolisthesis and the sacro-iliac joints are normal. COMMENT: COMPRESSION INJURIES INVOLVING L4 AND 1 MID DORSAL VERTEBRA SUSPICIOUS FOR OSTEOPOROTIC RELATED INJURY. Moje lekar opste prakse mi predlaze operaciju na koju se dugo ceka ovde u AUS, a kod privatnih bolnica je skupo za mene. Ja nastojim da nadjem i druge nacine lecenja, ako je moguce? Napominjem da sada osecam bolove u ledjima kada malo duze sedim, a narocito bolove u butini desne noge ako stojim ili hodam vise od 15 minuta, pa onda moram da sednem ili da legnem na stomak ako sam kod kuce. Unapred zahvalan.

Odgovoreno: 16. 03. 2008.