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    Old 04-29-2019, 05:32 PM   #1
    clyde2012
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    help understanding MRI results lower lumbar

    I have been having numbness and tingling from the knee down and after an EMG and a pressure test it was suggested it may be in my back. I finally got the results back and would like an honest opinion on the results. My brother had a fusion L5-S1 and has nothing but problems so I hope that is not where I am headed. Thank you for your help in advance.

    MRI L SPINE W/ and W/O CONTRAST:

    Techniques: Sagittal T1, T2, Stir, axial T1 and axial T2. The post-contrast axial and sagittal T1.
    Findings: There is a mild dextroscoliosis. The moderate to severe disk space narrowing is visualized at L4/5 level. L5/S1 level demonstrates a mild disk space narrowing. There is a disk desiccation at L3/4, L4/5 and L5/S1 levels. The bone marrow signals are patchy. The conus medullaris ends at L1 level without abnormal signal.
    L1/L2: The circumferential disk bulging is present, 4 mm in AP dimension. The central canal is 14 mm in AP dimension. The bilateral neuroforamina are mildly narrowed, especially on the right.
    L2/L3: The circumferential disk bulging is present, 5 mm in AP dimension. The central canal is 12 mm in AP dimension. The bilateral neuroforamina are moderately narrowed.
    L3/L4: The circumferential disk bulging is present, 6 mm in AP dimension. The central canal is 12 mm in AP dimension. The bilateral neuroforamina are moderately narrowed, especially on the right. There is a mild facet disease.
    L4/L5: The posterior disk bulging is present with osteophyte complex formation, 5 mm in AP dimension. The central canal is 13 mm in AP dimension. The bilateral neuroforamina are moderately to severely narrowed. There is a mild facet arthropathy.
    L5/S1: There is a posterior central disc protrusion, 6 mm in AP and 17 mm in transverse dimension. The central canal is 13 mm in AP dimension. The bilateral neuroforamina are moderately narrowed.

    IMPRESSION:

    1. The multilevel disk disease is visualized without central canal compromise.
    2. Multilevel neuroforaminal narrowing is present, especially at L4/5 and L5/S1 levels with moderate to severe neuroforaminal narrowing.
    3. The bone marrow signals are patchy, likely due to demineralization.
    4. Multilevel facet disease is present.
    5. Dextroscoliosis is visualized.
    6. L4/5 and L5/S1 disk space narrowing is present, more severe in the L4/5 level with multilevel disk desiccation.
    7. No abnormal contrast enhancement is visualized.

     
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    Old 04-29-2019, 07:54 PM   #2
    teteri66
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    Re: help understanding MRI results lower lumbar

    Welcome to the board. Before I go into the MRI results I would like to ask the following:

    Have you had lumbar spine issues in the last?

    Are you under the care of a spine specialist...orthopedic spine or neuro surgeon?

    What are your symptoms other than the numbness?

    How long have you had the numbness, etc. that you describe?

    What was the pressure test you mention?

     
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    Old 04-29-2019, 08:18 PM   #3
    teteri66
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    Re: help understanding MRI results lower lumbar

    I see you live where there are many fairly well-known spinal clinics! You should have a wide selection of spine surgeons to choose from, should it be necessary. I would be interested in knowing your age.

    You can see from the report that all your lumbar discs are showing signs of problems. The MRI report strikes me as being detailed in some ways but not comprehensive. It focuses on the disc herniations and the diameter of the central canal but doesn’t go into much detail about the facet joints, etc.

    Let me make a couple general comments about spinal MRIs. It is helpful to know that radiologists use specific adjectives to describe how “bad” an issue is. These words serve as a type of ranking and are, in order: minimal, mild, moderate severe.

    Again, generally speaking, minimal and mild issues are ignored. Moderate issues mean that conservative treatment measures will be tried and usually, surgery isn’t called for. Severe often means that surgery may be recommended...but, not always!

    The report indicates a fair amount of stenosis. This is a narrowing that occurs primarily in two places in the spine...in the central canal and in the neuroforamina, which are openings located at each vertebral level, where a spinal nerve exists the central canal and goes out to the part of the body it innervates. (If interested, you can look online for a “dermatome map.” This will show you which area of the body is innervated by which nerve.). When these areas become clogged up, it puts pressure on the nerve, which results in the symptoms we feel, either in the back or radiating out to the limb...pain, tingling, numbness, etc.

    When there is stenosis in the lumbar central canal, it can produce feelings of heaviness in the legs, discomfort when standing/walking, etc.
    “The AP diameter of the normal lumbar spinal canal varies widely from 15 to 27 mm. Lumbar stenosis results from an AP spinal canal diameter of less than 12 mm in some patients; a diameter of 10 mm is definitely stenotic and may be a primary source of symptoms.”

    Your issues appear to be worse at L4-5 and L5-S1.

    I would caution you to not try to compare your situation to your brother’s experience. Each spinal problem is unique as are the ways to treat and resolve it!

     
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    Old 04-30-2019, 09:51 AM   #4
    clyde2012
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    Re: help understanding MRI results lower lumbar

    I have had lower back spasms only if I have been walking and sit down quickly. I have a dull pain in lumbar region for the past 4 years but lately (past year) I have been having my lower leg go numb from the knee down on the outer portion of the calf. I have diabetes so the "pressure" test is called by the wrong name. They were checking the veins of my legs to make sure they were working correctly. I have an appointment with the VA to discuss the report but I wanted an idea of what to ask my primary about the report because it is hard to get into a specialist. I have decided if it is serious and my VA doctor does not take it as such I will schedule an appointment with a civilian spine specialist. Thank you for your reply

     
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