“What are the differences between a herniated disc, protrusion, and disc bulge?”
Hello, I'm a 26 year old male.
I'm currently in the process of enlisting in the military. My question pertains to the differences between a herniated disc, protrusion, and disc bulge.
I was in a minor car accident years ago and when I got home, I felt an immediate stinging pain in my shoulder and minor stinging pain in my mid-back. I had an MRI done. A shoulder MRI showed nothing serious and was fine. According to a radiologist at the time, MRI for the spine shows:
T6-T7: left paracentral protrusion type disc herniation WITHOUT cord compression (and with no neural impingement)
C3-4, C4-5, C5-6: shallow disc herniation/protrusion
L4-5: disc bulge and posterior annular tear with deformity of the ventral thecal sac
Based on the diagnosis, they seem a bit inconsistent, to me, at least. I was under the impression that a herniated disc was more or less defined as the "nucleus gel" compressing on a spinal nerve. The T-6/T-7 shows a "herniation", but "no compression", which is a bit confusing, and radiologist was not specific with C3 through C6, which is also confusing.
In the Department of Defense Instruction (the standard in the military that their doctors go by) it says the following as a disqualification:
"History of uncorrected nucleus pulposus associated with any treatment, symptoms, or activity limitations."
Based on their standards, is this something I should be concerned about when it comes to my spine and military entry? And is it at all possible that what the MRI showed may have been what my spine looked like before the accident?
I have no pain and I have not felt any type of pain since the accident 3-4 years ago. I've never had loss of motion or loss of strength, and my physical activity has never been limited due to the accident.
I have all of the records, including images of the MRI that was taken and used for the diagnosis. I'm no orthopedist, so it is difficult to pinpoint exactly where it shows said herniation - protrusion - bulge when I look at those images. Nonetheless, I strongly believe i didn't suffer any injury due to the accident.
If there is anyway that you can help with these questions for clarification, I would greatly appreciate your time.
Thanks a billion,
John Doe
I'm currently in the process of enlisting in the military. My question pertains to the differences between a herniated disc, protrusion, and disc bulge.
I was in a minor car accident years ago and when I got home, I felt an immediate stinging pain in my shoulder and minor stinging pain in my mid-back. I had an MRI done. A shoulder MRI showed nothing serious and was fine. According to a radiologist at the time, MRI for the spine shows:
T6-T7: left paracentral protrusion type disc herniation WITHOUT cord compression (and with no neural impingement)
C3-4, C4-5, C5-6: shallow disc herniation/protrusion
L4-5: disc bulge and posterior annular tear with deformity of the ventral thecal sac
Based on the diagnosis, they seem a bit inconsistent, to me, at least. I was under the impression that a herniated disc was more or less defined as the "nucleus gel" compressing on a spinal nerve. The T-6/T-7 shows a "herniation", but "no compression", which is a bit confusing, and radiologist was not specific with C3 through C6, which is also confusing.
In the Department of Defense Instruction (the standard in the military that their doctors go by) it says the following as a disqualification:
"History of uncorrected nucleus pulposus associated with any treatment, symptoms, or activity limitations."
Based on their standards, is this something I should be concerned about when it comes to my spine and military entry? And is it at all possible that what the MRI showed may have been what my spine looked like before the accident?
I have no pain and I have not felt any type of pain since the accident 3-4 years ago. I've never had loss of motion or loss of strength, and my physical activity has never been limited due to the accident.
I have all of the records, including images of the MRI that was taken and used for the diagnosis. I'm no orthopedist, so it is difficult to pinpoint exactly where it shows said herniation - protrusion - bulge when I look at those images. Nonetheless, I strongly believe i didn't suffer any injury due to the accident.
If there is anyway that you can help with these questions for clarification, I would greatly appreciate your time.
Thanks a billion,
John Doe
Male | 26 years old
Complaint duration: accident was 12/2016, treatment was minimal therapy for 2-3 months
Medications: n/a
Conditions: Herniated disc, protrusion, disc bulge
5 Answers
I obviously do not have your entire MRI and only one picture. You need to have the entire MRI to review to give a full opinion. But the picture you show does show bulging disks and loss of cervical lordosis. If you have no symptoms then there are no indications for restrictions and there would be no reason you would not qualify for the military. You can also perform normal sports activities and occupations. If that is disputed then you need to be examined and have a specialist provide a full report for the military. I have done that on a number of occasions. Best wishes. I hope you have the opportunity to serve your country.
Just looking at the one view of your cervical spine MRI shows a mild disc bulge.
A bulge is a normal small central protuberance that slightly changes a flat surface. They are seen in at least 30% of the normal population. A protrusion is the same but larger and may be off to one side or another. A herniation is a large protrusion that contains nucleus and it either presses on a nerve or the central canal. Your MRI looks similar to hundreds of other MRI's that I have seen in people in your age range.
Hope it helps!!
Dr. Bose
Hope it helps!!
Dr. Bose
Protrusion is a bulge which is normal. Hernia Yoon is an actual rupture.
The main thing is you're doing great so no reason to worry. The military will require an orthopedic consultation that clears you for active duty. I was a military doc and I also cleared enlistees after I got out.
If the Ortho consultant starts talking MRI or CT or an FCE (Functional Capacity Exam), politely ask why and can you just examine me and skip some or all of those tests? If not, Find another Orthopod that is willing to examine you and listen to your history of no dysfunction and no pain for 3 years. If the second gal says the same, then maybe you're stuck. You might try calling the Orthopods office first and asking if they are familiar with doing active duty clearance consultations and can they be done without an FCE or MRI? The radiologist that used the term "herniation/protrusion" was doing CYA, or CHA, covering her ass. The MRI you included do not usually show the disk changes you mentioned, Check the axial cuts for that. T or Thoracic disk herniations can almost never an issue.
Are you sure this is without a typo? "History of uncorrected nucleus pulposus associated with any treatment, symptoms, or activity limitations." It seems a term for herniated or displaced is missing.
Hope the helps.
If the Ortho consultant starts talking MRI or CT or an FCE (Functional Capacity Exam), politely ask why and can you just examine me and skip some or all of those tests? If not, Find another Orthopod that is willing to examine you and listen to your history of no dysfunction and no pain for 3 years. If the second gal says the same, then maybe you're stuck. You might try calling the Orthopods office first and asking if they are familiar with doing active duty clearance consultations and can they be done without an FCE or MRI? The radiologist that used the term "herniation/protrusion" was doing CYA, or CHA, covering her ass. The MRI you included do not usually show the disk changes you mentioned, Check the axial cuts for that. T or Thoracic disk herniations can almost never an issue.
Are you sure this is without a typo? "History of uncorrected nucleus pulposus associated with any treatment, symptoms, or activity limitations." It seems a term for herniated or displaced is missing.
Hope the helps.
