"There is a transitional vertebra at the lumbo-sacral junction consistent with partial lumbarisation of S1. There is degenerative change and disc space narrowing at L5/S1. There are small anterior osteophytes at the LS/L4 level and also on the superior aspect of L5."
So, class, what does that mean?
Keeny A: Sir, sir? He's falling to bits?
Well, student Keeny, something a bit more detailed would be welcome.
Swot A: Sir, I suspect this is all about a slipped disc, or, a more accurate description would be a herniated disc [looks smug]. The patient obviously has a problem at the junction of S1 and L5, illustrated here on my chart [points to help Keeny A understand].
Thank you, Swot. Anything else, class?
Swot B: Sir, I think the lumbarisation means that all is not well since the first sacral, S1, is beginning to behave like L5 due to the degeneration in the spinal column.
Keeny A: Oh sir, I was just going to mention that. But what's one of those osteophyte things?
Swot A: An osteophyte - if you'd done last week's homework instead of going to the pub - is a boney growth on the vertebrae and these can rub against each other - and against spinal nerves and other organs - causing pain, slightly worse than that hangover you had on Tuesday.
Keeny A: O, thanks...
Yes, thank you Swots A and B. So, there we have it class. Please inspect the diagram and memorise it for a surprise test in September...
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