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    Old 11-01-2012, 10:11 AM   #1
    truckerbill
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    help understanding mri

    findingsostoperative chages at L4-L5-S1 with susceptibility artifact from orthopedic hardware. degeneration of the L5-S1 disc noted. no significant spondylolisthesis. conus medullaris appears unremarkable.

    1: L1-2 andL2-3 levels show mild facet arthropathy.

    2:L3-4 spinal stenosis grossly unchanged. moderate facet arthropathy with fluid in the right facet joint. irregularity of the inferior aspect of the spinous process, consistent with prior fracture and/or postoperative changes has less abnormal signal and enhancement. resolution of the edema in this region, now with a sliver of curvilinear area of increased signal,consistent with fluid in the region between the osseous fragments.

    3:L4-5 postoperative chages. asymmetric clumping of the nerve roots.posterior arthropthy. narrowing of the thecal sac posterior to the superior aspect of L4 appears unchanged. slight increased truncation of the right anterolateral thecal sac posterior to the inferior aspect of L5 suspected. posterior enhancement and abnormal signal appear less prominent,likly postoperative. right foraminal narrowing L4-5 unchaged.

    4:L5-S1 postoperative chages with laminectomy. cystic areas adjacent to the left facet joint/orthopedic hardware have decreased in size. right foraminal narrowing/stenosis,grossly unchanged.


    any help understanding this would greatly help, thanks

     
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    Old 11-02-2012, 04:27 AM   #2
    truckerbill
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    Re: help understanding mri

    does anyone have an opinion regarding my mri findings,does it sound like something bad going on in my back.

     
    Old 11-02-2012, 04:32 AM   #3
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    Re: help understanding mri

    I hate to be the one to tell you this, but...."clumping of nerve roots" which it says you have is another way of saying arachnoiditis. This is a painful life long disease. I too, have arachnoiditis. There is no cure. Please research this. I'm assuming you are in a lot of pain???

     
    Old 11-02-2012, 04:35 AM   #4
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    Re: help understanding mri

    If you have any questions about arachnoiditis, please let me know.

     
    Old 11-02-2012, 05:10 AM   #5
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    Re: help understanding mri

    Are you in a lot of pain? Do you see a pain dr? Are you working??

     
    Old 11-02-2012, 07:29 AM   #6
    truckerbill
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    Re: help understanding mri

    yes i am in alot of pain. seen ortho dr said i have no reflex in left ankel and know my my right foot is in alot of pain he said he can not do nothing for me.

     
    Old 11-02-2012, 07:46 AM   #7
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    Re: help understanding mri

    Welcome to the board. Did this orthopedic doctor mention the nerve clumping to you? Was he the one he did your first surgery? Did you have a fusion from L4 to S1?

     
    Old 11-02-2012, 08:08 AM   #8
    truckerbill
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    Re: help understanding mri

    yes and did not seem to be to intrested in it,no he did not do the fusion on l4-5 l5-s1.

    should i be concered with no reflex in left ankle and pain in right foot.
    i have pain midline of my back as well of the low back. also numbness,pins and needles,shooting pain,and something that feels like electeral sensation in my legs.

     
    Old 11-02-2012, 09:51 AM   #9
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    Re: help understanding mri

    You should be concerned about no reflex in left ankle if that is a new symptom. More than likely it is a result of the issues you were having before the fusion surgery. If the nerve that controls that reflex has been damaged, there may not be much that can be done about it. Is it causing foot drop?

    All your symptoms point to one or more spinal nerves that are either irritated or compressed.

    I would suggest that you go for another opinion with either an orthopedic spine surgeon or a neurosurgeon who limit their practice to the neck and back. Your MRI report looks to me like there may be some issues that are causing your pain. You may have to visit several surgeons as some will not be interested in taking on someone who has had a previous fusion.

     
    Old 11-02-2012, 10:05 AM   #10
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    Re: help understanding mri

    If this dr is the one who performed your fusion, he's not going to want to mention arachnoiditis because it was likely caused by your surgery. He's not going to want to admit it. Most Drs are not interested in diagnosing arachnoiditis, because they either caused it, OR they just don't know enough about it to make the diagnosis. It's a deep, dark secret of the medical community. Your symptoms are consistent with the diagnosis. Any further surgery will worsen arachnoiditis!!! I would instead see a pain management doctor. If working has become difficult, arach IS a blue book listing for getting social security disability. As long as you have a doctor confirming the clumped nerve roots as arachnoiditis, you should have no trouble getting disability approved if you are ready to go that route. I'm on disability now. The only problem I had though was ONE neurosurgeon who i saw for a total of 5 minutes, incorrectly wrote in his notes that I did not have arachnoiditis, even though the MRI showed it, and I had other drs confirm it, so it took me a year and a half to get my disability. All because of one doctors mistake in medical records, and SS running with it. But it's all cleared up now!
    Good luck to you!

     
    Old 11-02-2012, 11:44 AM   #11
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    Re: help understanding mri

    Is most of your pain on the right side? For some reason it looks like you still have stenosis in the right foramen at L4-L5 and L5-S1. Stenosis is a narrowing in a passage where the nerves exit the spine out to the limbs. When it becomes clogged up, the nerves end up getting squished...which results in the pain you feel radiating down your leg, feelings of tingling, burning, muscle weakness, etc.

    L3-4 spinal stenosis grossly unchanged. moderate facet arthropathy with fluid in the right facet joint.

    At the segment above your fusion, there is stenosis in the central spinal canal and the facet joint on the right side is showing some moderate arthritic changes and seems to have some fluid build-up. Anything that causes an enlargement of a joint can cause pressure on those immediate nerves.

    The nerve clumping may or may not be significant. Further testing would need to be done to see if it is causing your pain. If a person is diagnosed with adhesive arachnoiditis, nerve clumping with be a part of the problem. However, people can have some nerve clumping without it causing arachnoiditis in every case...so do not panic over this finding of nerve clumping. It could prove to be fairly insignificant.

     
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    Old 11-02-2012, 12:00 PM   #12
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    Re: help understanding mri

    Quote:
    Originally Posted by teteri66 View Post
    Is most of your pain on the right side? For some reason it looks like you still have stenosis in the right foramen at L4-L5 and L5-S1. Stenosis is a narrowing in a passage where the nerves exit the spine out to the limbs. When it becomes clogged up, the nerves end up getting squished...which results in the pain you feel radiating down your leg, feelings of tingling, burning, muscle weakness, etc.

    L3-4 spinal stenosis grossly unchanged. moderate facet arthropathy with fluid in the right facet joint.

    At the segment above your fusion, there is stenosis in the central spinal canal and the facet joint on the right side is showing some moderate arthritic changes and seems to have some fluid build-up. Anything that causes an enlargement of a joint can cause pressure on those immediate nerves.

    The nerve clumping may or may not be significant. Further testing would need to be done to see if it is causing your pain. If a person is diagnosed with adhesive arachnoiditis, nerve clumping with be a part of the problem. However, people can have some nerve clumping without it causing arachnoiditis in every case...so do not panic over this finding of nerve clumping. It could prove to be fairly insignificant.
    While I certainly don't want him to panic, I have never seen nerve root clumping "not" be spinal arachnoiditis. I was told, when diagnosed (as well as in my different support groups) that "nerve root clumping" is the clinical findings used when diagnosing spinal arachnoiditis. Adhesive arachnoiditis is different, as it is the last, and worst stage of the disease, but as far as I know, nerve root clumping = arachnoiditis. At least that's what several doctors have told me.
    I think he should definitely have that looked into. I'm not trying to scare him, but he has the clinical findings, and it's generally hard to get diagnosed. But since its spelled out for him on his MRI it should be a lot easier. And he should at the very least get the diagnosis verified before having any type of back surgery as that would only worsen his condition.

    Last edited by Whynowthis; 11-02-2012 at 12:27 PM.

     
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    Old 11-11-2012, 04:59 AM   #13
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    Re: help understanding mri

    went to a new ortho and he said the same as the first one that its a failed back syndrom and there is nothing they can do surgical. they both said a inplanted spinal stim might work. any thoughts on that thanks

     
    Old 11-11-2012, 08:21 AM   #14
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    Re: help understanding mri

    Most doctors used the words "failed back surgery syndrome" instead of arachnoiditis. If you are not already in pain management, I would get started in a pain management program. You will want to limit any surgery, or injections on the spine. You may also want to join an online support group for arachnoiditis as they can explain things better as well. They can confirm what I've told you about the clumping of nerve roots. Also, be sure to do some online research as it should be able to confirm it as well. Unfortunately clumping of nerve roots is NOT an insignificant finding, it's something you don't want to see.

    Good luck to you!!

    Last edited by moderator2; 11-11-2012 at 12:19 PM.

     
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    Old 11-14-2012, 02:06 AM   #15
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    Re: help understanding mri

    went to pm for a consult about spinal stim,he told me my insurance has a 6 month waiting period for the stim. i just cant get a break. this happend at work my injury i have been fighting since july seen there dr he told them i needed this and that and adjuster sent a denial letter. it amazes me how they can get away with the stuff they do. no matter what im in it for the long haul.

     
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