Georgian Telemedicine Union (GTU)

Cases for review and consultation
First case (October 2,2005)

 Georgian Telemedicine Union (GTU)

 

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Patient: 34 years old male

At 27.09.2005 Magnetic-Resonance Tomography investigation of vertebrarium lumbar area in T2(tse), T1(se) impulse succession in sagittal and axial projections was performed.

The physiologic lordosis of lumbus in normal margins. Size of vertebrae unchanged. The lower dorsal edge of 5th lumbar vertebra is slightly truncated medially. The structure of 5th lumbar disc is non homogeneous. The mentioned 5th lumbar disc is displaced dorsad medially and mediolaterally by 10 mm, it is extended cranially by 9 mm. The compression of dura mater is revealed. The pressure upon right S1-route at vertebrarium canal’s inside part can be seen.

The holes between vertebrae are in normal margins. Pathologic changes in observed part of spinal cord are not revealed.  Para vertebral soft tissues unchanged.

Conclusion: Mediolateral rupture of L5 disc at right.

 

Questions: 1. Is this really rupture?

       2. What treatment can be recommended, conservative or surgery?

       3. If conservative treatment can be done, what scheme can be suggested?

       4. If surgical operation is recommended how quickly must be done it?

       5. Which clinics can be recommended? 

Comments:  Please, write Your opinion and the suggestions about this case to Eka Kldiashvili, Ph.D. kldiashvili@georgia.telepathology.org, Georgian Telemedicine Union (Association), Tbilisi, Georgia.

                            

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