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Old 11-10-2012, 05:14 PM   #1
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Want MRI results interpreted, please

I have read these results over & over. The neurosurgeons havent exactly been overflowing with information. Arachnoiditis. Thats all. Would like your valuable opinions! So, here it is. I hope you will take the time, i will be so appreciative. Thank you. Oh, & flexion and extension X- rays as well. All i have is final addendum. Here goes, Review MRI lumbar spine demonstrates peripheral clumping of nerve roots in the thecal sac from L3-L4 to caudally strongly suggestive of arachnoiditis. There may, in fact, be a tethering of the spinal cord, however this is felt to be most likely secondary to arachnoiditis. Thecal sac grossly patulous with peripheral clumping of nerve roots attached intradurally, to the dura itself and it appears to be mildly present into the epidural space @ L3-L4. However this is poorly visualized due to extensive epidural scarring/ fibrosis throughout. Conus tip is poorly seen but probably lies at the L2-L3 or upper L3 level. Poorly visualized most likely secondary to arachnoiditis.
***FINAL REPORT***
MRI LUMBAR SPINE WITHOUT AND WITH INTRAVENOUS GADOLINIUM
Multiplanar planar T1, T2 and T2 with fat suppression sequences of the lumbar spine were obtained,as well as post gadalinium T1 sequences.
FINDINGS: Spondylolisthesis of L4-L5is remarkable, moderately present. Mild levoscoliosis is evident. No fractures or destructive osseous lesions are detected. Marrow signal unremarkable.L1-S1 intervertebral discs are moderately dessicated & moderately diminished in height. Conus medullaris appears to terminate @ the L3 level. Conus mass not detected
findings @ specific levels:L5-S1 decompressive laminectomy noted. a 2mm broad based posterior protrusion is evident mildly effacing the anterior aspect of thecal sac. Thecal sac capacious @ this level. Moderate right neural foraminal stenosis is evident. Left foramen is patent. Bilateral mild Facet arthrosis is evident. L4-L5-- Status post decompressive laminectomy. Appx. 2.5 mm spondylolithesis of L4-L5 is present with 2.5 mm broadbased protrusion, mildly effacing the anterior aspect of thecal sac. Thecal sac capacious @this level. Bilateral neural foraminal stenosis. Bilateral facet arthrosis is evident.
L3-L4: No significant disc bulge is seen. Central canal is patent. Mild bilateral facet arthrosis is evident
L2-L3 same as L3-L4
L1-L2: 3mmbroad based posterocentral disc protrusion slightly effaces the anterocentral aspect of thecal sac Central canal is patent. Mild bilateral facet arthrosis is evident.zBilateral neural foramina remain patent.
IMPRESSIONS:
1. Tethered cord. Conus medullaris appears,though poorly visualized, to terminate at the L3 level, due secondary to arachnoidioditis.
2. Peripheral clumping of the nerve roots in the thecal sac from L3-L4 level caudally.
3. Status post wide decompressive laminectomy @ L4-L5 and L5-S-1. Subarachnoid space patent at both levels
4. 2.5mm spondylolisthesis of L4 on L5 with superimposed 2.5mm broad based posterior protrusion.
5. 2mm broad based posterior protrusion at L5- S1
6. 3mmbroadbased postercentral protrusion at L1-L2
7. Moderate right neural foraminal stenosis
8. Multilevel bilateral facet arthrosis, detailed above
9. Epidural fibrosis/scarring

Last edited by gmak; 11-11-2012 at 01:18 AM. Reason: have to finish

 
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Old 11-10-2012, 08:47 PM   #2
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Re: Want MRI results interpreted, please

Arachnoiditis is not terribly common, but your MRI certainly describes the typical findings.
The arachnoid is one of the 3 layers of the meninges which covers the spinal canal. Inflammation and consequent scarring of this weblike layer results in the clumping of the bottom strands of nerves at end of spinal cord. This usually results from a reaction to injections, like epidural injections or dyes fro myelogram, but it can occur spontaneously in people with inflammatory conditions like lupus or other connective tissue disease. I would have NO further injections or procedures on the spine, and if you have never had any, I would see a rheumatologist to get checked for connective tissue diseases. In addition, you have some moderate degenerative disc disease in the lumbar spine L1 thru S1 with drying out (dessication) of disc and loss of height (volume) to cushion your spine. There is forward slippage of L4 on L5 (spondylolisthesis), all of which adds up to bad back pain! The best approach might be a pain management specialist as well as rheumatologist to work on what might help you with pain relief.

Last edited by ladybud; 11-10-2012 at 08:50 PM. Reason: correction

 
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Old 11-10-2012, 11:46 PM   #3
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Re: Want MRI results interpreted, please

Thank you ladybud i had just started typing it actually when something happened and i couldnt finish, didnt mean to push submit just did out of habit i guess. Thank you for your time, thats was morethan ive heard from a dr! Whenever i type the rest will you look @ it again? I dont know how to get it off. Is there a time limit on "quote reply"? Or could i hit edit and finish? What should i do? I hate to leave it there & people like yourself take their valuable time. I will just finish it. Yes, i have pain! Major,but have been to pain dr over 10 years. Do the protrusions mean anything since we cant fix them anyway.Would this make me unstable like hard to sit up or on my feet? I know arachnoiditis can but thats all,right? Thank you for responding so quickly. Really more than i heard from 7 drs over the years!! Thank you so much.Ive had enormous help from people on this board, i knew nothing. The pain mgmt / anes drs only want to do procedures& surgeries & I left because of this. It IS bad for this condition? 3 neurosurgeons said no surgery. And, these pm drs only want to do spinal cord stim, pumps, or epidural injs. The first two are REAL cut the dura surgeries!

Last edited by gmak; 11-11-2012 at 01:33 AM. Reason: finished.ask question

 
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Old 11-11-2012, 12:56 PM   #4
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Unhappy Re: Want MRI results interpreted, please

Hi everyone, Please ALL of you that KNOW about reading MRIS so well, please tell me how bad or not bad this is!! The pain is atrocious. I want the truth from someone! ALL i've heard from the 5 drs is that I have arachnoiditis & one dr who said he didnt want me to know because the future would be so grim for me. I WANT to know how far down the line of AA am I? Or, maybe im still ok? Please, help with this. I know how much time that you have spent typing because of me. Thank you so much! But, Please one more time? The "MRI results people" that do this everyday on back problems board, please I would be so grateful! Thank you, I hope that you are just having a nice Sunday afternoon, and tomorrow that you will let me know. Worried. NEED HELP! Need to prepare, 2 times bottom of legs went numb & couldnt walk to get back to bed from bathroom. Feet wont pick up when walking! Cant wear "closed in" shoes! Feet hurt too bad when closed in shoes. Socks hurt, good thing I live in texas b/c 80°…balmy, in november! Please ya'll!
N

Last edited by gmak; 11-11-2012 at 07:05 PM. Reason: typos

 
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Old 11-11-2012, 07:21 PM   #5
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Re: Want MRI results interpreted, please

Since you have multiple reasons for back pain, it is pretty hard to assess which condition is causing the pain. Have you had epidural injections or any procedures in past? If not, treating any underlying disease, like connective tissue disease if present, may be a way to get pain relief. Also, a radiofrequency ablation of the nerves may be a consideration, since this is done outside the dura and nothing is injected. I would ask about that as a possibility and research it in terms of arachnoiditis. It burns the nerves that are being pressed on by the bulging discs so they cannot carry pain sensation. Since pain adds up, whatever portion of it is from the disc protrusions would be alleviated, and every bit of relief is worth something! I have had that done and it helped a lot for about a year. Can be repeated yearly if needed. I hope you get some help. The arachnoiditis is uncommon so not too much literature is available on it. Please do see a rheum, as the meds they use inhibit inflammation, the main problem in arachnoiditis and the nerve pain from protruding discs.

 
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Old 11-11-2012, 08:43 PM   #6
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Re: Want MRfI results interpreted, please

If this were my radiology report, I would want to find out further information pertaining to the possibility of a tethered spinal cord. Your spinal cord is longer than normal. Most end at the L1 but yours extends down to L3. This may be of no significance, but the report does indicate that there may be a tethered cord situation which, when discovered in an adult, can have many of the same symptoms as you describe.

Also I would attempt to find a doctor who is knowledgeable about arachnoiditis, (not an easy task, I realize,) and find out what stage it is IF you indeed have it.

I think you may need to get these two issues sorted out before you can really move ahead to address the other issues that are no doubt causing you additional pain.

 
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Old 11-11-2012, 10:46 PM   #7
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Re: Want MRfI results interpreted, please

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Originally Posted by teteri66 View Post
If this were my radiology report, I would want to find out further information pertaining to the possibility of a tethered spinal cord. Your spinal cord is longer than normal. Most end at the L1 but yours extends down to L3. This may be of no significance, but the report does indicate that there may be a tethered cord situation which, when discovered in an adult, can have many of the same symptoms as you describe.

Also I would attempt to find a doctor who is knowledgeable about arachnoiditis, (not an easy task, I realize,) and find out what stage it is IF you indeed have it.

I think you may need to get these two issues sorted out before you can really move ahead to address the other issues that are no doubt causing you additional pain.
Hi, thank you teteri for the info. This is so very confusing, but i continue. To research and search for a dr that can maybe help me somewhere in the world. Meanwhile, i have all these options to research. Oh for the joy of not having arachnoiditis. But, tethered cord sounds like no picnic. The confusing part is that if I have tethering only I could possibly have it fixed. With arach, cant be touched. Dr. Burton indicated that tethered cord was caused by arach. Like tarlov cysts can be. If i have both, idk who or what to do. If i looked on mri reports previous to arach & see where cord ended then & it changed, what would it indicate if it said that cord ended @ L1, that it stretched, shredded? I have been to the best place in texas (huge private university clinic that has all its physicians in 3 > 3000 bed famous hospitals & saw 2 NS there that were spine only. And, went to a practice limited to spine,neurosurgeon, in a practice limited to spine hospital. 1 said arach, cant touch. 1 said Arach, SCS only. 1 said arach, morphine pump. I didnt know @ any of the appts exactly what arach meant @ those visits. Not one explained. 1 moved from baylor to UT & goes to M.D.Anderson, Methodist, & Hermann now. Massive teaching hospitals! Like take up @12 city blocks,just one, & has 10-15, thirty three story bldgs. Each. But, that doesnt mean i saw the best NS for arach, tethered cord etc. Wow. Ok. This is my life. I will find out. What made you think that maybe I have a chance NOT to have arach? So, this MRI is bad, like real bad? The mri tech said to my
husband you have to see this & he looked. My husband said all he saw was white, everywhere, white. Scar tissue? I saw that my entire paraspinous muscles from SI to SI were solid whiteThank you. It helps me. God bless you.

Last edited by gmak; 11-12-2012 at 07:47 AM. Reason: typos & wording

 
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Old 11-11-2012, 11:19 PM   #8
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Re: Want MRI results interpreted, please

To ladybud, I have had an injury that blew holes in dura, 4 lum lams with dural grafting,epidural steroids, myelogram with pantopaque,nerve blocks, epi in labor, a 12 year stint with chronic ulcerative colitis now in remission. Naprosyn, toradol, lodine induced. And pain for 30 years. No one told me i had arach(1st showed on mri in 1988. Told 2012). Thank you for your great advice.

Last edited by gmak; 11-11-2012 at 11:21 PM. Reason: typo

 
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Old 11-12-2012, 03:16 AM   #9
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Re: Want MRI results interpreted, please

Hi gmak! There are only a handful of AA specialists in the country. Usually the best bet is to see a pain management specialist, and have NO further injections, or anything invasive! Have you actually seen Dr. Burton?

Last edited by Whynowthis; 11-12-2012 at 08:20 AM.

 
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Old 11-13-2012, 03:05 PM   #10
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Re: Want MRfI results interpreted, please

GMAK, the solid white on MRI is scar tissue. It is a travesty that no one told you you had arachnoiditis from 1988 to 2012! Especially if any these multiple procedures were done between those years, which likely made it worse. Not that money can make this better, but I would consider litigation against the original involved, f you weren't informed of the problem and advised to have no further procedure or injections, and had them after 1988. At least whatever you gained in compensation could make up for all you have spent in medical costs to treat this, not to mention the pain and suffering aspect. I am not a litiginous thinker, but in some cases it is a valid consideration. My cousin has arachnoiditis, and I requested some info from her about her SCS, which I know has helped her a lot (DENVER AREA). The Mayo Clinic may have some experts in this area. Worth checking out as well. Have you tried a TENS unit? You do have that autoimmune connection with the UC history. Interesting. I wish you the best in finding help and a Dr who can improve your quality of life!

 
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Old 11-13-2012, 03:21 PM   #11
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Re: Want MRI results interpreted, please

GMAK, some of your spinal issues fall into the arthritis category, and the antiinflammatory medications may help some of this pain. Also meds like Neurontin which suppress nerve pain may help. Have you been on Neurontin or Lyrica before? Worth a try. Also, a good strong back support brace might help with the pain from spondylolisthesis, the instability that causes unwanted movement of the vertebrae. A wide, double closure velcro support is best, one that has 2 layers, the underneath closes first and a second top layer closes next for extra cinching. It is worthwhile to treat everything wrong that you can to reduce the pain. Hope some of these things help.

 
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Old 11-13-2012, 04:34 PM   #12
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Re: Want MRfI results interpreted, please

Quote:
Originally Posted by ladybud View Post
GMAK, the solid white on MRI is scar tissue. It is a travesty that no one told you you had arachnoiditis from 1988 to 2012! Especially if any these multiple procedures were done between those years, which likely made it worse. Not that money can make this better, but I would consider litigation against the original involved, f you weren't informed of the problem and advised to have no further procedure or injections, and had them after 1988. At least whatever you gained in compensation could make up for all you have spent in medical costs to treat this, not to mention the pain and suffering aspect. I am not a litiginous thinker, but in some cases it is a valid consideration. My cousin has arachnoiditis, and I requested some info from her about her SCS, which I know has helped her a lot (DENVER AREA). The Mayo Clinic may have some experts in this area. Worth checking out as well. Have you tried a TENS unit? You do have that autoimmune connection with the UC history. Interesting. I wish you the best in finding help and a Dr who can improve your quality of life!




Dear ladybug, you are dear to help me. All of it happened between those years. Save the first 2 surgeries, myelogram, epi anes during labor. Is sentinel in st. Paul affiliated with Mayo? Also read article last pm, really early am. I have gnawing pain, Thats the one i cant handle! In article it states that the CSF being unable to drain into venous system causes that. Dr warnke in germany does a thecaloscopy & he opens valves so csf can drain again. Do you this would be viable option for me or a spit in the wind? Yes, i live on tens. I have 4. They really help.Think some dr does that in states? Thank you so much.

 
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Old 11-13-2012, 06:28 PM   #13
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Re: Want MRfI results interpreted, please

I'm not sure about Sentinel, but St Paul and Rochester MN are fairly close, and Mayo is in Rochester. If anyone does thecaloscopy I would bet Mayo clinic would know. I would not assume though that you have a CSF drainage problem. I think there would have to be some confirmation of that before even considering scope. The MRI doesn't mention anything about CSF blockage so you may not have that problem at all. I have a lot of pain too, in back and everywhere else. 3 back surgeries and countless epidural steroids plus a radiofrequency. I really think playing music during my awake hours helps distract my mind from it a little, as I tend to worry and focus more on my body when it is silent. If music is on, I focus on that and it helps. Sounds silly but every little bit helps with chronic pain.

 
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Old 11-14-2012, 04:21 AM   #14
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Re: Want MRI results interpreted, please

Quote:
Originally Posted by ladybud View Post
GMAK, some of your spinal issues fall into the arthritis category, and the antiinflammatory medications may help some of this pain. Also meds like Neurontin which suppress nerve pain may help. Have you been on Neurontin or Lyrica before? Worth a try. Also, a good strong back support brace might help with the pain from spondylolisthesis, the instability that causes unwanted movement of the vertebrae. A wide, double closure velcro support is best, one that has 2 layers, the underneath closes first and a second top layer closes next for extra cinching. It is worthwhile to treat everything wrong that you can to reduce the pain. Hope some of these things help.
Dear ladybug, i have a 2 layer back brace, i had forgotten about it. Thank you. I wish that i could take NSAIDS!but have history of ulcerative colitis, now in remission. I even tried toradol injections @ home but I react violently to the prostaglandin change. My gastro is afraid the pain is going to take me out of remission. But, so far 10 or so years & im still ok. I slide an ibuprofen by once in a great while. I have trouble sitting up, i lean on my elbows. Its not mentioned on mri but i have very little bone left holding up my upper body. Oh, yes I take lyrica 150mg bid. Baclofen 20 mg tid. The dr gave me zanaflex 4 mg, 1/2 tablet makes me unconscience, i cant take it. Even dropped baclofen & tried. No. Thank you so much, ladybud for everything.

 
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Old 11-14-2012, 04:41 AM   #15
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Re: Want MRfI results interpreted, please

Quote:
Originally Posted by ladybud View Post
I'm not sure about Sentinel, but St Paul and Rochester MN are fairly close, and Mayo is in Rochester. If anyone does thecaloscopy I would bet Mayo clinic would know. I would not assume though that you have a CSF drainage problem. I think there would have to be some confirmation of that before even considering scope. The MRI doesn't mention anything about CSF blockage so you may not have that problem at all. I have a lot of pain too, in back and everywhere else. 3 back surgeries and countless epidural steroids plus a radiofrequency. I really think playing music during my awake hours helps distract my mind from it a little, as I tend to worry and focus more on my body when it is silent. If music is on, I focus on that and it helps. Sounds silly but every little bit helps with chronic pain.
Dear lady bud, Im so sorry that you have terrible pain. I want to help you like you have helped me. I too use distraction to help with the pain. I use music too. If so bad that you have to have a "gown day"; Im not fond of tv, but, if "gown & down"( thats what we call it @ my home) I watch movies that are very intricate in the plot, or the setting, clothes, even the pictures on the wall. Like jane austen type movies or victorian settings in england. I watch, pause, rewind, making sure that i dont even miss a lace doily or a china pattern! And, i go outside & watch birds, squirrels, butterflies,even worker ants! Or read until full comprehension shakespeare, or famous poets, etc. All this helps tremendously. The eorse thing for me is to be in bed alone, quiet, awake in pain. On my mri is there some room for doubt that i dont have arach? About you, what kind of surgeries did you have if not too nosy? Is that why you still have pain? Thats what i was told for 30 years, until last summer when a NS literally dropped the A- bomb! Lol

 
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