Hello all, I was wondering if someone could explain some of these terms in simple terms for me. I have 2 reports and was wondering why the two would be so different? At least I think they are I'll explain as I go:
1st MRI report before surgery:
Findings: L1-2 disc normal. Neural foramen open.
L2-3 disc normal. Minimal facet hypertrophy.
L3-4 Disc has small focal prominence posteriorily just left of midline. Most consistent with very small herniation. Due to size, clinical significance would need to be questioned.
Mild-to-moderate facet hypertropy at this level. Neural foramen open.
L4-5 Mild focal prominence related to posterior aspect of disc central. Appearance is more suggestive of focal bulging as opposed to herniation.
Mild facet hypertrophy at this level. Some narrowing of the space available of the thecal sac and there may well be some mild central stenosis here. Neural foramina at this level open.
At L5-S1 there is marked focal abnormal prominence of the posterior aspect of the disc, to the left of the midline. The apprearance would be most consistent with a large herniation here. Given it's location, I would expect this to affect the descending S1 nerve root on the left here.
1. Herniation L5-S1 on left.
2. Very small herniation L3-4 to left. The significance of this questioned.
3. Some focal bulging L4-5 and possible mild central stenosis here.
Second MRI after surgery,I've had more but I'm just using these as examples: 02-02-05
MRI Lumbar spine.
Techniques T1 and T2 weighted image sequences in axial and sagittal plane were submitted through the lumbar disks.
Findings: Sagittal image sequences shows normal signal characteristic of the vertebral bodies with no evidence of masses or compression or fractures. Conus medullaris terminates normally at L1-2 level. The vertebral disks at L4-5 and L5-S1 has lost it normal bright signal on T2-weighted image consistent with degenerative disk disease. There are degenerative diskitis changes in the end-plates around the L4-5 and L5-S1 disk.
Axial images at:
L2-3 shows normal disk signal. No stenosis. Neural foramina, lateral recess and facet joints are normal.
L3-4 shows circumferential disk bulge. No stenosis. Neural foramina, lateral recess and facet joints are normal.
L5-S1 there is left paracentral disk extrusion with narrowing of the lateral recess. No significant spinal stenosis. There is posterior laminectomy in the level. The right lateral recess and neural foramen are patent.
1. Left paracentral disk extrusion at L5-S1 causing narrowing of the left lateral recess at that level. There is no spinal stenosis, however, There is posterior laminectomy at that level.
2. Circumferential disk bulge at L3-4 and L4-5 No significant spinal stenosis. : remail patent.
Ok now I realize that there are different ppl (radiologists if I'm correct), reading the impressions but the language from the 1st and 2nd MRI are very different to me. The first says mild stenosis and the second not. Can something like that just disappear? I did see narrowing, but not stenosis. Is narrowing meant to be the same thing? I understand what bulging, herniation and such are but the words like: Neural foramen, lateral recess and facet joints, Conus medullaris terminates normally at L1-2 level, Mild-to-moderate facet hypertropy, these are some of the examples if someone could help me with understanding terms. I would appreciate it greatly!!
I was telling my Ortho that I was having lots of pain and wanted an MRI and he just wouldn't do it for me. He told me he didn't feel it was necessary. After I was told that I felt like he was almost hiding something. To the eye, it looks as if nothing was done by MRI view. I am no Dr. so I could tell for sure, but I thought I would see a noticible different after having the surgery. I had "Bilateral L5-S1 decompression, and diskectomy on the left side L5-S1". I do feel if I am asking for something I should be able to get it. My ins. will pay so why not. I personally wanted to see what was done during surgery. So I kept asking every Dr. I saw and the one who finally did it almost a year after surgery was my PCP. I had my surgery in May of 04, and the MRI in Feb. Isn't that a shame. Thanks to everyone here. This is a great place to be.