It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board

Need Help interpreting MRI findings


Post New Thread   Closed Thread
LinkBack Thread Tools Search this Thread
Old 04-04-2013, 09:30 AM   #1
Mags0131
Newbie
(female)
 
Join Date: Mar 2013
Location: Cheyenne. Wyoming
Posts: 7
Mags0131 HB User
Need Help interpreting MRI findings

I had had severe back pain for years, recently I went for my followup thoracic and lumbar MRI and flexion/extension xray series. I would like some help understanding what I'm reading. I do have a followup appointment over the phone (I live in a different state than my doctor) but thats not for 3 more weeks.


[B]Thoracic MRI Findings:[/B]
Subannular disc protrusion (extending 2-3mm beyond the endplates) at T10-T11 and T11-T12 which reaches the ventral suface of the thecal sac but does not displace the cord itself. Both of these disc protrusions are just to the righ of the midline. There is a smaller disc protrusion just to the right of midline at T7-T8, this does not reach the thoracic cord.

[B]Lumbar MRI Findings:[/B]
The tip of the cornus medullaris terminates at T12-L1 and conus morhphology is normal. There is a diffuse of annular disc bulge at L5-S1 just reaching the ventral surface of the thecal sac and touching the traversing S1 nerve roots in the lateral recess. There is a tear in the outer annulus. At L4-L5 there is a diffusely bulging disc lying close to but not displacing the traversing L5 nerve roots bilaterally. Conclusion: There are disc protrusion at L4-L5 and L5-S1. At L5-S1 the disc touches the traversing S1 nerve roots bilatterly. Please correlate for S1 radiculopathy.

[B]Flexion/Extension Xray Findings:[/B]
There is mild wedging of the T10-T11 vertebral bodies with accentuation of the throacic kyphosis at that level. There is disc space narrowing at L5-S1.

What does this all mean and how is it treated? Is there hope that I could have less pain?

Also when I looked up the wedging of my thoracic discs all I could find was info about compression/wedge fractures. Is my disc fractured or was it at some point? How is that treated?

I appreciate any help you have to offer! Thanking for taking the time to read my post!

 
Sponsors Lightbulb
   
Old 04-04-2013, 11:40 AM   #2
gmak
Facilitator
(female)
 
Join Date: Oct 2012
Location: USA
Posts: 2,648
gmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB User
Re: Need Help interpreting MRI findings

[QUOTE=Mags0131;5157016]I had had severe back pain for years, recently I went for my followup thoracic and lumbar MRI and flexion/extension xray series. I would like some help understanding what i am reading.
[B]Thoracic MRI Findings:[/B]
Subannular disc protrusion (extending 2-3mm beyond the endplates) at T10-T11 and T11-T12 which reaches the ventral suface of the thecal sac but does not displace the cord itself. Both of these disc protrusions are just to the righ of the midline. There is a smaller disc protrusion just to the right of midline at T7-T8, this does not reach the thoracic cord.
[B]Lumbar MRI Findings:[/B]
The tip of the cornus medullaris terminates at T12-L1 and conus morhphology is normal. There is a diffuse of annular disc bulge at L5-S1 just reaching the ventral surface of the thecal sac and touching the traversing S1 nerve roots in the lateral recess. There is a tear in the outer annulus. At L4-L5 there is a diffusely bulging disc lying close to but not displacing the traversing L5 nerve roots bilaterally. Conclusion: There are disc protrusion at L4-L5 and L5-S1. At L5-S1 the disc touches the traversing S1 nerve roots bilatterly. Please correlate for S1 radiculopathy.
[B]Flexion/Extension Xray Findings:[/B]
There is mild wedging of the T10-T11 vertebral bodies with accentuation of the throacic kyphosis at that level. There is disc space narrowing at L5-S1.
What does this all mean and how is it treated? Is there hope that I could have less pain?
Also when I looked up the wedging of my thoracic discs all I could find was info about compression/wedge fractures. Is my disc fractured or was it at some point? How is that treated?
I appreciate any help you have to offer! Thanking for taking the time to read my post![/QUOTE]

Hi mags,
According to the radiologist the disc bulge at L5-S1 in your very low back has an annular tear which can be painful in & of itself but disc material is not pressing on your spinal cord but is on both sides directly touching the S1 nerve root which could be causing nerve root compression or just irritation because it is just touching the nerve & the radiologist mentions @ the L4-L5 level that the nerve roots on both sides left & right are not displacing the nerve root but @ L5-S1 he doesnt mention if the nerve root is displaced or moved at all & the radiologist is asking your dr to correlate this finding with your symptoms. When looking at a dermatome map the path that the L5 & S1 nerve roots take going down the back, buttocks, leg & toes is drawn out clearly to see which nerve is possibly causing symptoms. There are other disc bulges one @ L4-5 that is near the nerve root but does not appear to cause cord or nerve compression & the thoracic bulge doesnt appear to cause this either according to ehat the radiologist says.. The spinal neurosurgeon or a spine only orthopedic surgeon has the most education, training & experience in disorders of the spine & lof course determines the diagnosis after looking @ testing, taking all you history, symptoms & does a neurological exam to determine a course of treatment that can include medications like NSAIDS, muscle relaxers, PT, TENS, epidural steroid injections, etc or as a last consideration back surgery but depends on the severity that the surgeon determines of usually nerve compression that might lead to nerve damage if not corrected. I do not know about the wedging other than it is mild & the disc space narrowing @ L5-S1 is all the radiologist can see on a plain xray of the disc problem that shows on the MRI. I hope that the problem causing your pain is found & that you can find relief soon! Welcome to healthboards & please update us on your progress.

 
Old 04-04-2013, 02:31 PM   #3
Mags0131
Newbie
(female)
 
Join Date: Mar 2013
Location: Cheyenne. Wyoming
Posts: 7
Mags0131 HB User
Re: Need Help interpreting MRI findings

Thank you gmak for your response. I am seeing a specialist and I've tried pretty much everything under the sun except for surgery. They are suggesting an artifical disk replacement based on my other studies as I am not a good candidate for a fusion. In a few weeks I will have a phone consult with my doctor (I live in another state) so I guess we'll see then what all this means in a bigger picture. Again thank you for your time!

 
Old 04-04-2013, 04:40 PM   #4
gmak
Facilitator
(female)
 
Join Date: Oct 2012
Location: USA
Posts: 2,648
gmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB Usergmak HB User
Re: Need Help interpreting MRI findings

Hi, I hope that the problem & solution are found so that you can feel better. One thing i didnt know before back surgery was that a very high percentage are done for nerve compression not for pain relief as far as herniated disc like in my case. Did you look up a dermatome map so that you could see if where L5 or S1 are located is the site of your pain & do you have radiating pain?

 
Old 04-04-2013, 06:05 PM   #5
teteri66
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 8,998
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Need Help interpreting MRI findings

Disc wedging occurs when the front of the upper spine does not grow as fast as the back of the spine,resulting in vertebrae that take on a wedge-shape, with the narrow part of the wedge in front. The wedge-shape of the vertebra creates an increase in the amount of normal kyphosis (which is an abnormal rounding of the upper spine.) It has nothing to do with a fracture. (There is a condition that occurs that is called a wedge fracture, but this is not what is referred to in the MRI report. That would be a fracture of a vertebra.)

Since you only have this at one vertebral level and since it is ranked as "mild," it is probably the least of your problems.

I imagine your pain generators are stemming from the disc issues in the lower lumbar segments and the resulting nerve compressions at these levels. (It is hard to access the amount of "damage" as the report does not contain this information -- usually the reporter will either use measurements or the ranking words minimal, mild, moderate and severe.)

I would encourage you to research artificial disc replacement very thoroughly (both the pros and cons) before agreeing to the procedure. And I would encourage you to get several opinions from both neurosurgeons and orthopedic spine surgeons before agreeing to any type of surgery. It is never as simple or easy as they may lead you to think.

 
Old 04-11-2013, 03:09 PM   #6
Mags0131
Newbie
(female)
 
Join Date: Mar 2013
Location: Cheyenne. Wyoming
Posts: 7
Mags0131 HB User
Re: Need Help interpreting MRI findings

[QUOTE=gmak;5157231]Hi, I hope that the problem & solution are found so that you can feel better. One thing i didnt know before back surgery was that a very high percentage are done for nerve compression not for pain relief as far as herniated disc like in my case. Did you look up a dermatome map so that you could see if where L5 or S1 are located is the site of your pain & do you have radiating pain?[/QUOTE]
Thank you and me too. L5-S1 is definately the site of my pain and I do have radiating pain down the backs of both of my legs, sometimes sharp sometimes burning. I also experience a lot of the "falling asleep" sensations in my legs also, it occurs all the time, sitting, standing, laying, doesn't seem to matter what position I'm in. I also occasionally have a feeling like water is gently trickling down my ankles but there is never anything there. I have a desk job which is torture on my back and I find myself constantly having to switch positions as to avoid things falling asleep. Although standing isn't any better, if I could get away with laying in bed all the time I think I would feel much better. I also have an autoimmune disease, so between my back and that I pretty much never ever feel well. I know that surgery is not something to be taken lightly but I am not sure what else to do at this point. I've also been suffering from gastroparesis and constipation so there is some question as to whether some malfunction in my nerves are causing those issues. I had a phone follow up the other day with my neurosurgeon and they want me to do an EMG now. I have heard some pretty bad stories about EMGs so it's got me fairly nervous. I have no clue what they are hoping to gain by giving me this test but I hope it gets me one step closer to some kind of relief. Thanks again for your response.

 
Old 04-11-2013, 03:23 PM   #7
Mags0131
Newbie
(female)
 
Join Date: Mar 2013
Location: Cheyenne. Wyoming
Posts: 7
Mags0131 HB User
Re: Need Help interpreting MRI findings

[QUOTE=teteri66;5157265]Disc wedging occurs when the front of the upper spine does not grow as fast as the back of the spine,resulting in vertebrae that take on a wedge-shape, with the narrow part of the wedge in front. The wedge-shape of the vertebra creates an increase in the amount of normal kyphosis (which is an abnormal rounding of the upper spine.) It has nothing to do with a fracture. (There is a condition that occurs that is called a wedge fracture, but this is not what is referred to in the MRI report. That would be a fracture of a vertebra.)

Since you only have this at one vertebral level and since it is ranked as "mild," it is probably the least of your problems.

I imagine your pain generators are stemming from the disc issues in the lower lumbar segments and the resulting nerve compressions at these levels. (It is hard to access the amount of "damage" as the report does not contain this information -- usually the reporter will either use measurements or the ranking words minimal, mild, moderate and severe.)

I would encourage you to research artificial disc replacement very thoroughly (both the pros and cons) before agreeing to the procedure. And I would encourage you to get several opinions from both neurosurgeons and orthopedic spine surgeons before agreeing to any type of surgery. It is never as simple or easy as they may lead you to think.[/QUOTE]

Thank you for that info Teteri. I thought it was stange also that the tech did not report the amount or severity of the damage, but where I live it seems like all the medical professionals here do a less than thorough job and I've started to have to travel out of town just to find doctors who eve deal with the issues I have.

I have seen an orthopaedic surgeon who recommended a disk replacement, a neurosurgeon who recommened a multilevel fusion and my current neurosurgeon who is also recommending an artifical disk replacement. I have had multiple surgeries on other body parts, some good, some not, so I know all too well its never as easy as it seems and some doctors are willing to cut into you without much thought because it makes a nice profit for them.

 
Old 04-11-2013, 05:42 PM   #8
teteri66
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 8,998
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Need Help interpreting MRI findings

I've been traveling and didn't see your earlier post. Don't worry about having an EMG/nerve conduction study...but again, have it with a neurologist you know to be reputable and experienced. Physiatrists also do this (doctors of Physical Medicine and Rehabilitation.) For the most part, it sounds worse than it is.

It is somewhat useful to determine if your nerve compression is damaging a particular nerve. Mostly it confirms what the doctor already suspects. Your MRI report said: " Please correlate for S1 radiculopathy." I imagine this is why you are having the EMG.

There should be a radiologist who read the MRI and wrote the report.

Last edited by teteri66; 04-11-2013 at 05:45 PM.

 
Closed Thread

Tags
back pain, disc protrusion, mri help, mri report interpretation



Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is Off
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 10:12 PM.





2018 MH Sub I, LLC dba Internet Brands. All rights reserved.
Do not copy or redistribute in any form!