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Old 05-01-2011, 04:47 PM   #1
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Unhappy Need Help Understand MRI - Thank You

Clinical History: Chronic midback pain for two years with no known injury.
Technique: MRI of the thoracic spine was performed utilizing a 3 Tesla magnet without the administration of gadolinium contrast. Comparison: Radiographs of the thoracic spine on 1/22/2008.
Comments: Vertebral body heights and anatomic alignment are preserved throughout the thoracic spine. There are scattered degenerative endplate changes with anterior endplate spur formation as well, and there are scattered hemangiomas in the thoracic spine. No focus of suspicious bone marrow signal alteration is identified. Spinal cord is of normal course and caliber without evidence of focal abnormality. Note is made that the large imaging field of view may obscure subtle cord lesions. On the sagittal count down localizer sequence, there is evidence of cervical spondylosis with disc osteophyte complexes from C4-5 through C6-7 leading to varying degrees of central canal stenosis incompletely evaluated on the current exam. Further evaluation may be obtained by dedicated MRI of the cervical spine if clinically warranted.
At T3-T4 and T4-5, there are tiny central protrusion type disc herniations.
At T5-T6, there is a right paracentral small protrusion type disc herniation with associated bony proliferative changes with posterior osteophytic ridging mildly narrowing the right lateral recess. The central canal and neural foramina are, otherwise, patent.
At T7-T8, there is a small left paracentral protrusion type disc herniation.
Central canal and neural foramina remain patent.
At T8-T9, there is a small-to-moderate right paracentral protrusion type disc herniation indenting upon the anterior thecal sac without evidence of cord compression. The central canal remains patent measuring 10 mm in AP dimension. The neural foramina are patent.
At T10-T9, there is a small right paracentral protrusion type disc herniation with associated bony proliferative changes mildly narrowing the right lateral recess. The central canal and neural foramina are, otherwise, patent.
There are varying degrees of facet hypertrophy throughout the thoracic spine. In the upper lumbar spine, there is evidence of posterior annular tears and underlying disc bulges at L1-2 and L2-L3 incompletely imaged on the current study. Further evaluation may be attained by dedicated MRI of the lumbar spine if clinically warranted.
Impression: 1. Small scattered disc herniations and varying degrees of facet hypertrophy in the thoracic spine without evidence of central canal and neural foraminal stenosis.
2. Evidence of cervical spondylosis and degenerative disc disease in the lumbar spine incompletely evaluated on the current exam. Further evaluation may be obtained by dedicated MRI of the cervical and/or lumbar spine if clinically warranted.

Last edited by zephrah; 05-01-2011 at 04:50 PM.

 
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Old 05-01-2011, 06:18 PM   #2
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Re: Need Help Understand MRI - Thank You

Hi. I'm Jenny and one of the people who does a lot of interpreting of spine MRI results. I have major spine problems and injuries and 2 major spine surgeries in my neck. I am fused from C3 to T2 due to breaking my neck.

Your thoracic MRI basically says you have a lot of arthritis and some small bulging disks that do not affect any of the spinal nerves and only compress the lining of the spinal cord and not the cord itself. This probably causes a lot of pain and aching but is not anything that needs fixing.

But they did spot possible problems in the cervical and lumbar areas that might be causing you a lot more problems and should be looked at. Problems in the neck can cause pain anywhere from the level of the problem down so pain in the mid-back can be coming from the neck. Get it checked out.

Let me know what the the next one says and I'll be glad to help you understand it.

hugs........Jenny

 
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Old 05-01-2011, 07:23 PM   #3
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Re: Need Help Understand MRI - Thank You

Thank You Jenny, I go back to the MD on the 4th and I will let you know what happens next. I truly appreciate your reply.

Last edited by zephrah; 05-01-2011 at 07:26 PM. Reason: corrected typos

 
Old 05-22-2011, 04:21 PM   #4
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Re: Need Help Understand MRI - Thank You

Quote:
Originally Posted by jennybyc View Post
Hi. I'm Jenny and one of the people who does a lot of interpreting of spine MRI results. I have major spine problems and injuries and 2 major spine surgeries in my neck. I am fused from C3 to T2 due to breaking my neck.

Your thoracic MRI basically says you have a lot of arthritis and some small bulging disks that do not affect any of the spinal nerves and only compress the lining of the spinal cord and not the cord itself. This probably causes a lot of pain and aching but is not anything that needs fixing.

But they did spot possible problems in the cervical and lumbar areas that might be causing you a lot more problems and should be looked at. Problems in the neck can cause pain anywhere from the level of the problem down so pain in the mid-back can be coming from the neck. Get it checked out.

Let me know what the the next one says and I'll be glad to help you understand it.

hugs........Jenny

 
Old 05-26-2011, 02:38 PM   #5
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Re: Need Help Understand MRI - Thank You

Hi Jenny,
This is the latest Lumbar MRI

Exam: MRI of the lumbar spine dated 18 May 2011.
Clinical Indication: Patient having chronic sharp midback pain to low back pain
for two years. No known injury. No history of cancer or surgery.
Technique: Standard images were obtained on a 3.0 Tesla Phillips MR scanner.
Findings: There is a possible cyst on the posterolateral cortex of the left
kidney. There is an edema pattern seen in the L4 and L5 vertebrae around the
disc space. This probably represents degenerative disc disease. Edema pattern
endplate change is seen at the L5-S1 level on the left.
L1-L2: There is diffuse disc bulge. Degenerative facet disease is seen.
L2-L3: Diffuse disc bulge is seen. Degenerative changes are seen in the facet
joints. The neural foramen are open.
L3-L4: Diffuse disc bulge is seen. Hypertrophic facet changes are evident. The
neural foramen is mildly narrowed on the left.
L4-L5: There is diffuse disc bulge. Hypertrophic facet changes are seen. The
neural foramen are narrowed mildly bilaterally, worse on the right than on the
left.
L5-S1: There is diffuse disc bulge with left sided dominance. There is severe
narrowing of the left neural foramen with near obliteration of the perineural
fat. Degenerative change is seen in the facet joints. There is mild narrowing of
the neural foramen on the right. Hypertrophic facet changes are seen.
Impression: 1. There is broad based left preforaminal and lateral disc bulge with moderate
severe narrowing of the neural foramen on the left.
2. There is prominence of the ligamentum flavum at the L5-S1 level, it measures
6.5 mm.
3. Degenerative facet disease.
4. Edema endplate change is seen at L4-5 and L5-S1.
5. Possible cyst on the left kidney, this is incompletely evaluated on this
study.

Thank you for you help. I appreciate your help and understanding.

Sincerely,

Zephrah

Last edited by zephrah; 05-26-2011 at 02:53 PM. Reason: typos

 
Old 05-26-2011, 03:49 PM   #6
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Re: Need Help Understand MRI - Thank You

You have had the pain for two years it seems. What treatment have you had and what did they tell you was wrong with you. If you had treatment did it help. Do you have only pain or do you have weakness or other signs.
James

 
Old 05-26-2011, 06:07 PM   #7
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Re: Need Help Understand MRI - Thank You

Quote:
Originally Posted by james079 View Post
You have had the pain for two years it seems. What treatment have you had and what did they tell you was wrong with you. If you had treatment did it help. Do you have only pain or do you have weakness or other signs.
James
Hi James,

Thank you for your response to my post.

At first, physical therapy. When the PT read it was Degenerative Disc Disease, they released me, saying nothing could be done for me. I have only been given medication, flexeril, robaxin, now Lortab. At times I use a TENS Unit. No other treatment.

I don't have any other weakness. My only pain is directly under my right shoulder blade. The same place all the time, constant.

I am new here so I don't know who I actually respond to, that's why I addressed this to "Jenny"

Thank you,

Zephrah

Last edited by zephrah; 05-26-2011 at 07:04 PM. Reason: correct typo

 
Old 05-26-2011, 07:22 PM   #8
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Re: Need Help Understand MRI - Thank You

Quote:
Originally Posted by zephrah View Post
Hi James,

Thank you for your response to my post.

At first, physical therapy. When the PT read it was Degenerative Disc Disease, they released me, saying nothing could be done for me. I have only been given medication, flexeril, robaxin, now Lortab. At times I use a TENS Unit. No other treatment.

I don't have any other weakness. My only pain is directly under my right shoulder blade. The same place all the time, constant.

I am new here so I don't know who I actually respond to, that's why I addressed this to "Jenny"

Thank you,

Zephrah
You said "When the PT read it was DDD they released me, saying nothing could be done for me"
Strange PTs, if they didn't treat patients with DDD there would hardly be any one left to treat after 30 years old!
James

 
Old 12-02-2011, 11:47 AM   #9
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Re: Need Help Understand MRI - Thank You

Hi Jenny, I'm new here. Would you help me understand my latest MRI? I had microdiscectomy (?) two years and am still having problems. I don't quite understand what the most recent MRI states. Thank you

 
Old 12-02-2011, 12:06 PM   #10
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Re: Need Help Understand MRI - Thank You

Be glad to if you post the report. Make sure to include words like mild, or moderate, severe and even minimal...they are a rating system for how bad things are. I'll explain along with the rest of the MRI.

Jenny

 
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Old 12-02-2011, 10:27 PM   #11
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Cool Re: Need Help Understand MRI - Thank You

Ok thanks, here goes,
T12-L1: Central disc protrusion without foraminal or central spine canal compromise.
L1-L2: Moderate-sized broad-based disc bulge causes mild to moderate central canal stenosis. Neural foramen are patent.
L2-L3: Small broad-based diffuse disc bulge and mild ligament flavum thickening and facet arthrosis causes unchanged mild to modertae central canal stenosis in mild foraminal narrowing.
L3-L4: Small diffuse diffuse disc bulge and mild facet arthrosis appears similar.
Post surgical changes from partial right laminectomy and partial ligamentum flavin removal appear similar.There is persistent moderate formanial narrowing, with borderline central canal stenosis.
L4-L5: Moderate diffuse disc bulge and moderate facet degenerative change with right laminectomy similar. There is mild central canal stenosis with mild to modertae right and left formanial narrowing.
L5-S1: Mild facet degenerative change without foraminal or central canal stenosis.
Thanks for any help, maybe I can understand this in laymans terms. I was hoping the surgery would have solved everything, too much faith I guess.
Joe

 
Old 12-06-2011, 11:50 AM   #12
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Re: Need Help Understand MRI - Thank You

You might want to check out another part of the forum where most of the people with lumbar issues hang out -- you will find us on the "Back Ptoblems" section of the HealthBoards Message Boards.

I never noticed this category before today!!

 
Old 12-06-2011, 03:32 PM   #13
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Re: Need Help Understand MRI - Thank You

Jpden....just now saw your MRI report....but I sliced the tip of my middle finger earlier and as soon as I can get it to stop bleeding, I'll be glad to post about what I read. Haven't forgotten you but I've been very busy and now...let's just say I'm a bit of a klutz.

Should be back later tonight.

Jenny

 
Old 12-06-2011, 05:45 PM   #14
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Re: Need Help Understand MRI - Thank You

Quote:
Originally Posted by Jpden View Post
Ok thanks, here goes,
T12-L1: Central disc protrusion without foraminal or central spine canal compromise.
L1-L2: Moderate-sized broad-based disc bulge causes mild to moderate central canal stenosis. Neural foramen are patent.
L2-L3: Small broad-based diffuse disc bulge and mild ligament flavum thickening and facet arthrosis causes unchanged mild to modertae central canal stenosis in mild foraminal narrowing.
L3-L4: Small diffuse diffuse disc bulge and mild facet arthrosis appears similar.
Post surgical changes from partial right laminectomy and partial ligamentum flavin removal appear similar.There is persistent moderate formanial narrowing, with borderline central canal stenosis.
L4-L5: Moderate diffuse disc bulge and moderate facet degenerative change with right laminectomy similar. There is mild central canal stenosis with mild to modertae right and left formanial narrowing.
L5-S1: Mild facet degenerative change without foraminal or central canal stenosis.
Thanks for any help, maybe I can understand this in laymans terms. I was hoping the surgery would have solved everything, too much faith I guess.
Joe
Okay Joe, here we go. You do know that the spinal cord itself stops about T12 and all you have are the remaining nerves hanging down loosely within the spinal canal. If those are involved, they call it Cauda Equina Syndrome. Most of the pain however, comes from compression of the spinal nerves that exit to either side of the vertebrae.

T12-L1....bulging disk but it does not impact the spinal canal or cord or the spinal nerves that exit on either side

L1-2.....larger bulging disk but this time, it causes "Mild to Moderate" blockage of the spinal canal but it not hitting the nerves in the canal. And the nerves that exit are also okay. They rate the amount of blockage with the words Minimal, Mild Moderate and Severe. If you assign the words a number value, then you have blockage of your canal that is 2-3 out of 4....4 being severe. I know in the neck they generally operate when you hit 3 but in the lumbar, they usually go further as fewer nerves are involved but the neck has a full size spinal cord.

L2-3.....here again, you have a 2-3 out of 4 canal blockage from both a disk bulge and the ligament that holds the vertebrae together thickening up. Looks like you had surgery before to remove part of that same ligament so you know it's an issue. And the facet joints have mild arthritis(who doesn't these days!). They are involved with twisting motions. But here, the hole where the spinal nerves exit to the body are closing up and are a 2 out of 4 in the blockage scale.

L3-4.....You've had surgery here and so your canal is open with only a tiny amount of blockage. the facet joint still has mild arthritis but the big problem seems to be that the openings for those spinal nerves has not improved and is now a 3 out of 4 in blockage...OUCH! That is the cause of major pain HOWEVER, most spine docs won't fix until you reach the severe level(4 out of 4).

L4-5......a larger disk bulge and worse arthritis in those darn facet joints but your "lami" has kept the canal pretty open....it's a 2 out of 4. Those spinal nerves have a compression of 2-3 out of 4.

L5-S1.....mild facet arthritis and the canal and spinal nerve openings both look good.

I know how frustrating it is to have more problems but I'm now facing my 3rd neck surgery because the first 2 were from the back and they now need to go from the front and take out the bad disks....similar to your problem. They widened the spinal canal for you(from the back I take it) but disks have to be removed from the front. And it looks like he didn't do any foraminotomies when in there either(opening those holes for the spinal nerves). they usually wait until you are "severe" before doing that and on the canal, they usually won't do anything until you are moderate to severe or have symptoms of bladder and bowel incontinence or you can't go(Cauda Equina Syndrome).

So you are right on the edge of needing more surgery but not quite there yet...frustrating isn't it! I'm in the same boat with my lumbar...almost but not quite yet.

Hope this helps you to understand...I wish I could help you more. Any questions, ask away.

Jenny

 
Old 02-02-2012, 12:40 PM   #15
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Question Re: Need Help Understand MRI - Thank You

don;t understand my recent Mri either. no treatment then for narrowing of disc canals? other than pain management?

 
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