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腰痛腿無力

病患者男 - 29歲

9月時地下濕滑滑倒後, 一開始只是輕微的腰痛,右腳少少無力。過兩日後, 行幾步路已經無力到要停一停休息,開始麻痺。 接受了物理治療及食消炎止痛藥1個月,起初有少少見效,右腳只是間歇性的麻痺, 後來已經無什麼見效了。2年前, 曾經做過L5/S1腰椎間盤切除手術。
磁力共振報告:
The conus medullaris is normal in signal intensity and ends at L1 level. The lumbosacral spine is anatomic in alignment with normal lordosis. The lumbosacral spine vertebral bodies are normal in height. A small focal bony defect at right L5/S1 posterior arch is noted, suggestive of postoperative change. Desiccation of L5/S1 intervertebral disc with mild reduced intervertebral disc height is seen. Small peripheral lumbar vertebral osteophytes and mild bilateral lower facet joint osteoarthritic changes are present. Findings are suggestive of mild background degenerative changes. A small focal T2W hyperintense signal is noted at posterior annulus of L5/S1 intervertebral disc, suggestive of a small annular tear. At L4/L5 level, mild bilateral posterolateral posterior disc protrusion is noted. The central spinal canal and lateral recesses are patent. Mild bilateral neural foraminal stenoses are seen. At L5/S1 level, mild posterior disc bulge with indentation of anterior thecal sac is noted. The posterior annulus of the L5/S1 disc appears slightly irregular, probably postoperative change. The central spinal canal, lateral recesses and neural foramina are patent.
報告顯示應該是輕微的,但為何到現在都差不多3個月,都沒有什麼再有進展,右腿依然會走一段少路已經無力、酸痛,腰痛持續,是否不會完全康復?
洪亮斌醫生回覆: [ 12/9/2021 ]
MRI報告的確沒有明顯神經根受壓,因此腿部症狀或與背肌及梨狀肌在受傷後發炎繃緊有關。建議向骨科醫生求診,作詳盡檢查。

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