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    Old 03-06-2006, 08:42 AM   #1
    wolfmarket
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    Mri-please Comment

    Any comments?

    FINDINGS: Small chronic Schmorl's node endplate deformities are seen at several levels and mild Modic type 1 discogenic endplate change is present at L2-3 and L3-4. Mild spondylosis is present primarily ay L2-3. No fracture is seen. There is no spondylolisthesis. There is mild lumbar scoliosis convext to the left.

    The L1-2 disk is partially desiccrated and mildly reduced in height. Small central posterior disk protrusion deforms the thecal sac without narrowing the spinal canal. The neural foramina are patent bilaterally.

    The L2-3 disk is partially desiccated and mildly reduced in height. Small left paracentral posterior disk protrusion is again identified, narrowing the left lateral recess. There is additional contralateral small right posterolateral foramina disk protrusion. There is mild to moderate bilateral neural foraminal encroachment. The canal is within normal limits.

    The L3-4 disk is desiccated and reduced in height. Mild to moderate paracentral posterolateral disk protrusion is again identified. There is underlying posterior disk bulge, facet hypertrophy, mild spinal stenosis and bilateral neural foramina encroachment, mild right, moderate left.

    The L4-5 disk is desiccated and reduced in height. Small central posterior disk protrusion is present. there is facet hypertrophy, mild spinal stenosis and mild bilateral neural foraminal enroachment.

    IMPRESSION
    1.SMALL CENTRAL POSTERIOR DISK PROTRUSION AT L1-2
    2.LEFT PARACENTRAL POSTERIOR DISK PROTRUSION AT L2-3, NARROWING THE LEFT LATERAL RECESS AND NEURAL FORAMEN; CONTRALATERAL RIGHT FORAMINAL DISK PROTRUSION AS WELL.
    3.MILD TO MODERATE LEFT PARACENTRAL POSTEROLATERAL DISK PROTRUSION AT L3-4
    4.SMALL CENTAL POSTERIOR DISK PROTRUSION AT L4-5

    All comments welcome!

    Alan

     
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    Old 03-06-2006, 05:26 PM   #2
    Suzy-Q
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    Re: Mri-please Comment

    Hello Alan -
    I'm sure I can't parse all this for you but I can welcome you and point out a few highlights. Welcome! Well, you sure have a lot of red letter vocab words here: spondylosis, disc dissacation, and disc protrusions are never good findings. However, the distance between not good and 'operable' is sometimes very great. Protrusions in combination with stenosis or neural or foraminal narrowing are a seriuos problem. This is where the pain and disfunction often come from and thus are often when and where you'll hear of surgery options. Likewise, facet hypertrophy is often linked to stenosis (or narrowing) of the nerve root space and will explain pain and debility. Dissication is describing shrinkage of the disc and when this happens the disc space often collapses bringing two vertebra closer together. This again is not a good thing but isn't always by itself a huge problem.
    I've not heard of Schmorl's endplate deformities - a new one to me. The summary points really address what your doc will need to act upon (and that action may be no more than an ice pack). You have issues from L1 to S1 but the combination of disc disease (bulges, protrusions) and recess, canal, or foraminal narrowing (stenosis) taken together suggest your L2-3 and L3-4 are your hot spots. Are you going to have any more tests? I ask because it is not clear what your symptoms are and there are a number of places that your pain may be coming from. I would press your docs to tell you how they will determine where your pain is coming from before you choose a treatment plan. But a very little time on this board will educate you to the fact that many a person has gone into a major surgery to 'fix' L2-3 and come out of it in equal pain only to learn much later that it was that normal looking disc at L5-S1 that was hurting all the time. That isn't the most likely thing to happen but this board is the testament of the minority outcome! The best of luck to you - Suzy-Q

     
    Old 03-06-2006, 08:40 PM   #3
    wolfmarket
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    Re: Mri-please Comment

    Thank you for your comments. Actually, I'm a long timer on HB although I usually frequent the pain management board.

    I do have severe pain for which I currently use the 100 mcg Fentanyl Patch and 30 mg of Roxicodone for BT. The Roxis help tremendously while the patch really doesn't. My PM Doc won't rx OxyContin even though the Roxi's worl great for m e and he does Rx that. Go figure.

    2 surgeons have said I'm not surgical, so...


    Alan

     
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