MRI Findings, Nervous and in pain

11-14-2010, 04:28 PM

Good evening everyone. I am the new guy on here. I have been browsing the boards for a while and also doing research on my own. I am a 23 year old male who has been having issues with my back, hips and radiating pain for a long time. The hip and back pain since high school, but the radiating pain and severe outer thigh pain for about two years or so. I am on tramadol, neurontin, skelaxin, vicodin, ibuprofen. I recently recieved the results from my MRI and I really am nervous about the findings and impressions, and here is how the MRI report reads:

IMPRESSION:

Minimal left paracentral disc bulge/protrusion at L5-S1. No significant central canal or foraminal compromise noted in the lumbar spine.

PROCEDURE:

Inversion-recovery, T1-, and T2-weighted images of the lumbar spine were obtained in multiple imaging planes without intravenous contrast. No comparison study.

FINDINGS:

Conus medullaris has normal signal intensity and terminated at T12.

L1-2 through L3-4: No evidence of [B]significant [/B]central canal or foraminal narrowing.

L4-L5: Minimal disc bulging. Bilateral facet hypertrophy. No [B]significant [/B]central canal or foraminal narrowing.

L5-S1: Invertebral disc dessication. Mild disc bulge with minimal component of shallow left paracentral protrusion. There is no [B]significant [/B]displacent of the S1 nerves. There is no [B]significant [/B]central canal narrowing. There is facet hypertrophy bilaterally. There is no significant canal compromise.

I am just unsure exactly what the MRI is saying. I have been trying to do reasearch. And I know I will have to ask my doctor, but the MRI states "significant" many times. Does significant mean there is a problem? I see my doctor tomorrow, just wondering if anyone else has any answers. Thank you for your time and God bless.

11-14-2010, 05:46 PM

Unless I am reading it wrong your report repeatedly says NO significant. Meaning that the findings are nothing significant which is a good thing. I am sure your doctor will explain things to you but for now the findings look pretty good. Good luck and I hope you begin to feel better. Sometimes these things can take a long time to resolve.

11-15-2010, 09:08 AM

Your MRI results sound like mine did in 03-08.. Mine however stated a 5mm disc protrusion, and annular tear posterior and centrally at l5-s1 and DDC at l4-l5 with facet hypertrophy. I was in a mva in july 08 and since I could feel the left side sciatica, starting in my buttocks and ending at the outer top of my foot.. Ive had 1 round of epidural injections and also facet joint injections and still no pain releif.. I went to neursurgeon and he ordered another MRI and due to the mva and stress on the disc at l5-s1 the protrusion has enlarged the tear is larger and leaking chemicals onto the sciatic nerve.. He has reccomended a PLI which will be done through endoscopic/microscopic in a 1-2 inch incision on each side of the spine and the hardware(screws, rods) inserted through the small incisions.. Very similar to a microdiscectomy in which the heal time is usually a few weeks and then a period of pt.. I may return to normal activites after pt and appt follow-up.. You need to be careful and monitor your symptons and if they get worse request another MRI and injections may help the pain, if not see a orto spine or a neurosurgeon Dr.. PT may be ordered and surgery should be your last resort!!!

11-16-2010, 09:49 PM

There is likely to be some narrowing of the spinal canal and foamina (opening in the vertebrae) with a bulging/protruding disc. If these areas are narrowed excessively, you can have compression of the spinal cord or major nerves. Lack of significant narrowing means that the spinal cord itself is very likely okay, and reduces but does not eliminate the likelihood of nerve compression or trauma. MRIs do not have sufficient resolution to detect compression or trauma to thin nerve bundles, so it is never possible to rule out nerve involvement by reading an MRI. The nature and distribution of your pain is often more valuable of a diagnostic tool than any imaging studies, particularly when the images show very minor amounts of damage. Much of the pain that is localized to your back may be due to the facet hypertrophy, but the shooting pains are almost certainly due to compression/entrapment or trauma involving a nerve bundle not easily seen on the MRI. Any pain symptoms that don't appear to be related to MRI findings should still be treated as a primary symptom. If your doctor brushes you off by saying something like "Nothing in your MRI explains why you're having so much pain," consider making an appointment to see a pain doctor, preferably in a pain clinic setting. These doctors have generally received at least one to two additional years learning about pain syndromes that do not show up in diagnostic imaging.

Best of luck to you.

MRI Findings, Nervous and in pain

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