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Old 06-24-2012, 12:48 PM   #1
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MRI results need help

I am close to mid 50's. In a nutshell, I had a slip and fall at my place of employment (no longer there) 11/10, 12/10 my doc ordered an MRI, 01/11 I got it done. No one called me. I figured it must be okay and tolerated the pain, I am a minimizer. Spring 2012 I can no longer tolerate it any more. I go back to doc, receive referral to Ortho; he does x-ray's, tells me I had a problem with L-5, S-1, gives me 2 shots. I call my doc office and find out the MRI done 01/11 did in fact show problem too. Now I am attempting to have W/C reopen this case as I found out they closed it. The shots helped a bit, but soreness never went away, the shots are wearing off now after 2 weeks and I don't go back for 3 weeks to see Ortho. So if someone could help me interpret these results and suggest anything I would appreciate it. The pain hurts when I lie down or sit, sometimes walking helps, but not much. I am not on - nor do I want to be on any narcotics. I historically have a high tolerance for pain. (also, never was told I have scoliosis before)

MRI: L Spine wo

Comments: Multi-planar MR images were obtained of the lumbar spine. There is normal alignment of the lumbar spine on the sagittal images with mild curvature to the left compatible with scoliosis. The conus is at the L1 level. Vertbral level is assuming 5 lumbar type vertra. The para spinal soft tissues are normal. There is spurring of the end plates.

At the T11/12 to L2/3 levels there is no evidence of stenosis of the canal, foramina or lateral recesses and the AP diameter of the canal is 12 to 14 mm. There is normal signal of the discs at these levels with no evidence of abnormality. The foramina are patent.

At L3/4 there is normal signal of the disc with no disc bulge. There is mild spurring of the facets with facet joint fluid and moderate ligament thickening causing mild posterior narrowing of the canal. The AP diameter of the canal is 12mm. with triangular cross section. There is mild narrowing of the lateral recesses and formina.

At L4/5 there is desiccation of the disc with mild disc bulge. There is mild spurring of the facets with facet joint fluid and moderate ligament thickening causing mild posterior narrowing of the canal. The AP diameter of the canal is 11mm. with triangular cross section. There is mild narrowing of the lateral recesses and formina.

At L5/S1 there is desiccation and mild loss of disc height. There is moderate spurring of the facets with ligament hypertrophy. There is mild narrowing of the canal with diameter of the canal is 11mm. There is no narrowing of the lateral recesses. There is mild narrowing of the formina.

Impression: There is facet spurring with ligament thickening at multiple levels. There is mild to moderate foramina narrowing.

Thank you for any help. I much appreicate it.

 
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Old 06-24-2012, 06:53 PM   #2
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Re: MRI results need help

I'm trying to figure out if this is a serious injury report or just something I can live with.

 
Old 06-24-2012, 07:02 PM   #3
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Re: MRI results need help

hi I just typed a long reply and lost it, ugh! but anyway, looks like you have a mild disc bulge/hernation that may or may not be causing a problem but defintely have narrowing of the spinal canal (stenosis). You also have some bone spurs at multiple levels. I'd get a 2nd injection and see if that helps. I hope this helps, cj

 
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Old 06-24-2012, 08:04 PM   #4
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Re: MRI results need help

This is a thorough report -- much more detailed than most we see on here.
If you hadn't mentioned your fall at work, I would tell you that from what is described in the report, the changes in the spine are of a degenerative nature...wear and tear type issues that most of us develop sooner or later.

They are the type of changes that probably take years to develop -- bone spurs and stenosis. These are a result of arthritic-type changes in the spine, particularly in the facet joints.

These are the synovial joints that allow the spine to bend forward, backward and to twist side to side. Each vertebra has two sets of facet joints. One pair faces up and one downward. There is one joint on each side (right and left) and they link the vertebrae together. As we age, the discs begin to lose height and the facets begin to lose their smooth surface. As the body struggles to maintain stability, it lays down osteophytes and ligaments thicken. But instead of these things helping to stabilize the spine, they contribute to the development of stenosis, which is a narrowing or clogging.

There are two main areas where the spine develops stenosis. One is in the center spinal canal and the other is in the foramen...which are openings through which spinal nerves exit the spine and go out into the body. In a normal situation, there is enough room for the nerves. However, when these openings become clogged up, it can result in less room for the nerves, which can result in nerve irritation or nerve compression. It is the irritation or compression that occurs at a segment in the spine but can send pain radiating out to the extremities. (in the case of the lumbar spine, the spinal nerves innervate part of the pelvic area, buttocks, legs, feet and toes. Each spinal nerve carries signals along a specific "route." You can look up a "dermatome map" to see which area is innervated by which spinal nerve.)

One important thing to note is that radiologists use specific language to describe the severity of an issue -- minimal, mild, moderate and severe. Usually when an issue is described as mild, as is your foraminal stenosis at
L3-L4, L4-L5 and L5-S1, it can be dealt with using conservative treatments.

However, the MRI is just one piece of the diagnostic puzzle. The spine specialist will correlate this to what is found upon physical exam, a basic neurological exam, and a thorough history of your pain symptoms. Pain caused by degenerative facets can be very painful...but I don't see anything that sends up a red flag indicating the need for surgery.

 
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Old 06-25-2012, 12:21 PM   #5
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Re: MRI results need help

Okay so what do you do if your tail bone feels like it is broken? Seriously!

 
Old 06-25-2012, 12:22 PM   #6
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Re: MRI results need help

Also, I met a lady today and she said that many people go to their grave not knowing they have these issues with their back, but trauma, such as a fall or auto injury can bring them to the surface and cause other problems.

 
Old 06-25-2012, 01:56 PM   #7
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Re: MRI results need help

I don't think you mentioned anything about your tailbone pain in the first post, did you? Has this been sore since your fall in 2010? Have you had it x-rayed?

 
Old 06-25-2012, 06:32 PM   #8
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Re: MRI results need help

No I hadn't mentioned it. It only started hurting about a month ago; and that is why I sought treatment again.

 
Old 06-25-2012, 06:52 PM   #9
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Re: MRI results need help

And yes I asked the doc to x-ray it and it only showed arthritis.. I think is what I was told and then sent to Ortho.

 
Old 06-25-2012, 09:32 PM   #10
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Re: MRI results need help

It is possible that you cracked the coccyx when you fell, and then it healed on its own. Or it may be sensitive from the initial fall and you have irritated it again.

Mostly you just wait it out. It can be extremely painful.

You might want to read up on it: Coccydynia

 
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