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farella 01-26-2016 02:51 PM

help me understand my mri report
I'm trying to understand this MRI report can someone please explain this in normal terms? Mild lumbar levorotoscoliosis ? L2-3 level: Anterior disc bulge displaces the prevertabral soft tissues? L3-4 level: Loss of disc height and hydration with disc bulge effacing ventral epidural fat indenting the anterior thecal sac. Posterolateral disc bulge narrows the medial aspects of the bilateral neural foramina. Anterior Large disc herniation with underlying annualar tear displaces the prevertebral soft tissues abutting the posterior margin of the aorta? L4-5 level:Diffuse circumferential disc bulge effaces ventral epidural fat indenting and compressing the anterior thecal sac. Producing mild central and bilateral recess stenosis. Neural formina are patent. Anterior disc herniation with annular disruption displaces the prevertebral soft tissues? L5 S1: Broad based disc bulge incompletely effaces ventral epidural fat. Mild facet arthropathy narrows the medial aspects of the bilateral neural foramina? Okay I think I got it all, basically i'm in lots of pain, I've been through therapy and steriod shots. Do these findings look like I could use surgery?

teteri66 01-27-2016 07:05 AM

Re: help me understand my mri report
Welcome to the board. As I hope you know, none of us are doctors...just fellow spineys sharing information and experiences. First, let me say that a MRI is one piece of the diagnostic puzzle. The doctor correlates its findings with what is found on physical exam, basic neurological exam and after listening to the person's description of symptoms and how they affect daily life. But just looking at the report, I think it is doubtful that surgery would be recommended at this point. Pain is not enough reason to recommend surgery (as incredible as that sounds to someone suffering with back and radicular pain!). Usually there needs to be nerve compression or instability before surgery will be considered.

The MRI indicates what could be lumped together as degenerative disc disease. This is a collection of symptoms that often begins with the deterioration of the disc that leads to additional problems. Intervertebral discs are mostly comprised of "water." They serve as a cushion or shock absorber between the bones of the spine, and along with the face joints, allow the spine to bend and twist. As we age, and aging of the spine begins in our 20s, discs tend to lose moisture and flatten out. As this happens, the disc space narrows, bringing the bones closer together. This sets off a series of cascading an attempt to stabilize the segment, little bony growths form, joints enlarge, tissue calcifies, and the narrow canals where nerves pass out from the spine become clogged.
The report indicates that some of these degenerative changes are going on at several levels.

There is a slight curve of the lumbar spine, curving to the left. There are disc bulges at L2-3 and at L3-4, in addition to a larger disc bulge, there is a small tear in the outer layer of the disc...and the location of the bulge is toward the front and apparently pushing into the edge of the aorta, which is the largest artery in the body.

Similar disc bulges occur at L4-5 and L5-S1 causing some stenosis. This term means "narrowing." It can occur where nerves are particularly vulnerable to being compressed...the central canal, neuroforamen or a teeny canal called the recess.

The reason why I can see that things would be painful but probably do not require surgery is that nothing is judged to be severe...stenosis is mild, facet arthropathy (ARTHRITIC TYPE changes in facet joints) is mild. But again, I am going on the report only. It is important to see a spine specialist for an accurate diagnosis and plan of treatment.

CathyAD 02-05-2016 04:55 PM

Re: help me understand my mri report
what does it mean when it says mild to moderate or just moderate? Is moderate worse then mild then and cause more pain?

teteri66 02-05-2016 05:31 PM

Re: help me understand my mri report
The ranking is as follows: minimal, mild, moderate, severe. The words are an evaluation or judgment of the radiologist to give an indication of "how bad" something is. It technically has nothing to do with pain. Sometimes a huge disc bulge causes no symptoms and conversely, a small disc bulge that doesn't look like it should be causing symptoms, can be very painful.

Most spine surgeons do not read the radiology reports but look at the images and do their own evaluations.

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