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Old 10-18-2012, 08:29 PM   #1
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Question Need help understanding MRI results

Mild straightening of the physiologic lumbar lordisis. Partial disk desiccation and mild intervertebral disk height loss are present at T12-L1, L3-L4 and L4-5 levels.
Conus medullaris terminataes grossly at the level of T12-L1.

T12-L1: Circumferential disk bulge, without spinal canal stenosis.
L1-L2 Annular disk bulge, without spinal canal stenosis or significant foraminal narrowing.
L2-L3 Mild circumferential disk bulge,without spinal canal stenosis or significant foraminal narrowing.
L3-L4 2.5 mm AP circumferential disk bulge with prominent foraminal components and mild facet arthrosis result in mild bilateral foraminal stenosis. Mild spinal canal stenosis, with a thecal sac diameter of approx. 9.7 mm AP at midline.
L4-L5 3.2 mm AP circumferential disk bulge, slightly eccentric to the right, and fact arthrosis reselt in the right lateral recess stenosis, borderline central spinal canal stenosis,moderate to severe right and mild to moderate left foraminal stenosis. The descending right L5 nerve root contacts hypertrophied facets and bulging disk within the lateral recess. The exiting right L4 nerve root is in contact with hypertrophied facets within the neural foramen. Small right facet joint effusion.
L5-S1 No significant posterior disk abnormality. Probable right and questionalb left L5 pars defects. Bilateral facet arthrosis results in mild to moderate bilataeral foraminal stenosis.

Impression: At L4-5 level, 3.2 mm AP circumferential disk bulge, and facet arthrosis result in right lateral recess stenosis, borderline central spinal canal stenosis, moderate to severe right and mild to moderate left foraminal stenosis. The descending rigfht L5 nerve roots contact the hypertrophied facets and bulging disk within the lateral recess. The exiting right L4 nerve root contacts the hypertrophied facets with the neural foramen. Probable right and questionable left L5 pars defects, which may be further confirmed by means of CT.

 
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Old 10-19-2012, 09:41 AM   #2
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Re: Need help understanding MRI results

Catluvr,
I am so sorry you didn't get any replies. I think this happened because none of us are doctors, we are not able to explain to you what this all means.
Reading your report, personally I may have some ideas due to my own experience, but I wouldn't mislead you with my unprofessional 2 cents.

I am sure your Dr is your best bet, only he may explain to you what exactly your problem is.

Good luck to you
Moldova

 
Old 10-19-2012, 10:36 AM   #3
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Re: Need help understanding MRI results

I'm not a doctor either but I know how frustrating it is to have a copy of the report but not understand it. I can't tell you "what's wrong" but I can help you to understand some of the terms.

Basically one of the major things that leads to the nerve pain many of us experience is caused by stenosis. This can occur in the central canal or in the foramen, which are openings the nerves pass through as they exit the spine. When the foramen get "clogged" up, the opening is smaller and there isn't enough room for the nerve...so it ends up getting squeezed or compressed.

Stenosis means "narrowing." it can be caused by a variety of different issues: a disc can bulge out of its space and press into the foramina; there can be arthritic changes in the spine that cause the facet joints which are located at each vertebra and connect the vertebrae together, to enlarge or thicken, or develop bone spurs. This takes up what should be open space...and results in spinal nerve compression.

Since the spinal nerves carry signals of movement and sensation to all parts of the body, when a nerve is compressed in the lower back, it can result in that pain you feel radiating down the leg, maybe even into the foot. If it is a cervical issue, it can lead to pain in your arms, shoulders, or hands....each nerve has a specific path...so we know that when
[B] The descending right L5 nerve roots contact the hypertrophied facets and bulging disk within the lateral recess. The exiting right L4 nerve root contacts the hypertrophied facets with the neural foramen.[/B] it can cause pain that runs down the thigh and if it extends into the foot, it can cause pain and numbness in the big toe (L4) and the 3 middle toes (L5).

The first three disc bulges, between T12 and L3 are probably not causing a problem as they are not causing nerve involvement and are not large in size.

The effects appear to be worse with the next two disc segments. At L4-L5 the disc bulge is not large as these things go, but it is having an impact at both the left and right foramen and to a lesser extent, in the central canal. The facet joints are showing signs of arthritis changes and degeneration...wear and tear.

At the final lumbar level, L5-S1, the disc appears to be OK, but there are other issues that should be examined further. A possible pars defect is mentioned. This is a possible crack in a small bone, the pars, that may mean that there is a potential of a condition called spondylolisthesis, where one vertebra slides over the adjacent vertebra, in this case, allowed due to a defect in the pars....the writer suggests this be confirmed with a CT scan, but another method is with a flexion/extension x-ray, which will indicate what happens when you bend forward or backward to the l5-S1 segment. In addition the facet joints are enlarged and beginning to encroach into the adjoining foraminal space, causing stenosis.

Hope this helps you understand your report. When do you see your doctor for an interpretation of the findings?

 
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Old 07-17-2013, 10:09 AM   #4
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Re: Need help understanding MRI results

Lord, your back sounds like mine, I start at the C3-7 which are nearly bone on bone, a annular tear at T12, bone spurs, bulges from the T11-13. L3 annular tear, L4/5 compression fracture, impinging on S1. Nothing conservative has worked to lesson the pain, and the L4/5 just got popped out of place this past year, which cause pain down both legs like I never experienced before. I know heating pads are discouraged, but it was the only pain relief I could get. The cold packs only made the pain worse.

 
Old 07-17-2013, 12:58 PM   #5
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Re: Need help understanding MRI results

If you have chronic pain, you can use either heat or ice, whatever works. I bought a far infrared heating pad and it really saved me while I awaited surgery. They are quite a bit more expensive but well worth it in my opinion. I don't understand the technical details, but the wave lengths are different and penetrate much deeper rather than just heating the surface. You can find them and read about them online.

 
Old 07-17-2013, 07:40 PM   #6
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Re: Need help understanding MRI results

I found the hand warmers hunters use, and stick one in a sewed up pot holder and pin it over the lumbar, the heat last 10 hrs, just enough to bring the pain down. They have to be padded as they exceed 130 degrees and will burn older fragile skin fast, Any skin for that matter. They will NOT consider me for a candidate for surgery. I have 3 auto immunes 4 if you count hypo thyriodism and osteoporosis to go with the Osteo A.

 
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