I was injured about 3 months ago. I have a "a pretty good/big sized" lumbar disc herniation and was told that I also have spinal stenosis and that I have a disc/discs that are "blown out" (they showed black on the MRI)
I was wondering if someone on here that knows more could maybe translate my MRI for me? I know it's in English and looks like it's been "simplified" already, but I still would like to know exactly what it all means.
TECHNIQUE: Coronal T1w, sagittal T1W and T2W and axial T1W sequences of lumbar spine and axial T2W sequence through intervertebral dis spaces were obtained on a 1.5 TESLA unit.
FINDINGS: There is a normal lumbar marrow signal except for mild spondylotic endplate marrow signal at L4-5. There is normal lumbar alignment and no compression fracture is demonstrated. Intervertebral disc spaces are well preserved except for mind narrowing at L4-5. At L4-5, there is moderate midline disc herniation with moderate compression of the thecal sac and right lateral recess. Lumbar spine canal is normal in caliber. Neural foramina are widely patent. The conus medullaris is normal in size and position, terminating at L1 level.
Impression: Moderate midline dic herniation at L4-5
I'm not sure who the comments that you have in quotes are from, but they seem to suggest greater "damage" that the MRI radiology report states.
It is important to remember that the MRI may show something that is less than 100% normal that is not causing the patient a bit of pain. Sometimes something will be noted that is only discovered when the patient has im.aging for another purpose. Therefore, any imaging is just one piece of the diagnostic puzzle. The physician will also perform a physical exam and take an oral history and ask the patient to describe any symptoms. This information will all be combined and correlated by the doctor -- putting all the pieces together -- to come up with the diagnosis.
In writing a radiology report, there is specific language that is used to describe the extent of a problem. When you see the words "mild" and "moderate," it indicates that some issue out of the ordinary is noted, and is worth keeping an eye on, but it is nothing that would require immediate treatment. Surgeons would not recommend surgery for a problem accessed as being mild or moderate.
Everything in your lumbar spine is noted as being normal, with the exception of the L4-L5 segment. At this level, there are some signs of arthritic type changes that are showing on the endplate, which is the edge of the vertebrae. There is a slight amount of narrowing of the disc space at this level, and there is a "moderate" disc herniation at this level as well.
At L4-5, there is moderate midline disc herniation with moderate compression of the thecal sac and right lateral recess. The disc bulge is pressing into the thecal sac and right lateral recess, which could result in some nerve compression. This is the only stenotic issue noted in the report.
Everything else is "normal." Alignment is good. No compression fractures are found. The central canal is of normal size. (When it is smaller than normal, it can be a cause of stenosis.) The foramina are open ("widely patent"). The foramina are openings through which the spinal nerves exit the spine. They can also be a source for stenotic problems...but yours are normal and open...no nerve compression.
The impression is the area where the radiologist sums up his findings. You will see that it states there is moderate disc herniation at L4-L5.
There is nothing to indicate that discs are "blown out." If discs show black on MRI, it indicates they are losing their moisture and are drying out. Usually the report will refer to "disc dessication" which is not mentioned in your report.
Unless the spine specialist finds things on physical exam that are not showing up on the MRI, you should be able to treat your problems using conservative treatments -- probably some physical therapy and oral medications, perhaps a steroid injection if it is warranted.
Herniated discs can and do heal on their own without surgical intervention. The very small amount of stenosis that is mentioned shouldn't be causing you any major problems. If it were bad and compressing a nerve, it would be referred to as "severe."
Hope this helps. What type of doctor will you be seeing to find out the results of the MRI and what plan there is for treatment?
Thank you so much for your reply and for simplifying what my MRI says!
This was a work related injury. I've never had any back issues until that horrible "pop/pull" sensation and the horrible pain that followed. I'm going through the workers comp system, I was sent to a walk in clinic where they gave me medicine and sent me to 18 physical therapy sessions. After the pain not changing and me asking a couple of times, I was finally sent for an MRI and was referred to an orthopedic surgeon. This doctor then told me that he didn't recommend surgery and sent me to a pain management doctor. I had my first ESI this past Thursday. I feel like it's helped but I still have sharp stabbing pain when I move (walk, sitting and shifting positions), not all the time but it's still there.
I have not been able to work for the past 3 months, my job requires me to be on my feet, walking around while carrying things all day long. Standing and sitting for long periods of time made my right lower back hurt and a burning/pressure/tingling sensation would run down my right leg constantly. I had to constantly lean to my left side or hold on to something while walking. If I walked for longer than 15 minutes, the pain would intensify. I go in for the 2nd ESI in about 2 weeks.
Disc herniation will take some time to recover from. My husband herniated two discs in his lower back almost 10 years ago. He was out of commission for almost a year. He did not have surgery, and only rarely has problems with his back.
It drives me nuts that so many doctors send a person with a back injury for physical therapy BEFORE doing x-rays or MRI's. It has to be one of the dumbest things I have ever seen. They did the same with my husband.
Hang in there, take it easy on yourself, and don't push things too fast. It will take time, but things should improve!