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    Old 01-18-2016, 10:53 PM   #1
    JAM661
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    Help with understanding MRI

    Hi,
    I had a MRI done about 8 years ago that I mention that I had severe and advance DDD from L1 -S1 along with a few other problems. A few days ago I had another MRI done and the DDD is not even mention. I have had no surgery or procedures so I am sort of wondering what happened. There some new terms that have come up that I need some help in under standing what is on the report. This is what the results of my last MRI taken a few days ago.

    There is prominent levoscoliosis. There are postsurgical changes suggestive of prior right hemilaminectomy at L4-5. There is transitional anatomy with partial sacralization of L5. At L4-5 circumferential disc bulge with spondylitic ridge and severe bilateral neural foraminal narrowing which may be slightly more pronounced on the right. There is a large amount of material extending into the left lateral recess at the l4-5 level but is thought to represent extruded disc material that may be having some mass effect on the traversing left nerve root. At L3-4 there is mild bilateral neural foraminal narrowing which may be slightly more pronounced on the right. At L2-3 there is circumferential disc bulge with spondylitic ridge narrowing at lateral recesses greater on the right and mild bilateral foraminal narrowing.

    My major concern about not having the severe DDD listed is that my family doctor no longer wants to prescribe opiate medication for her chronic pain patients. My concern of course is finding a pain clinic/doctor who will find my issues warrant my medication.
    Any comment would be welcome. Thanks

    Last edited by JAM661; 01-18-2016 at 10:55 PM. Reason: Left something out.

     
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    Old 01-19-2016, 02:45 PM   #2
    teteri66
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    Re: Help with understanding MRI

    My guess is that DDD was not mentioned because what else you have going on that is mentioned is the result of further degeneration, and it goes without saying that you have degenerative disc disease.

    You say you have had no surgeries on your spine? This report would indicate otherwise! It states there appear to be post surgical changes that look like you have had a laminectomy on the right side at L4-5.

    There is a bulging disc at L4-5 that is causing a number of issues. While the writer doesn't say the disc has ruptured, there is a mass that looks like disc material coming from the disc. This material is coming out of the disc space and pushing into the lateral recess, which is a tiny little canal that connects the central canal area to the foramen. The foramina is an opening located at each vertebral segment where the spinal root exits the spinal canal and goes out to innervate a particular part of the body. When either of these places is narrowed due to excess tissue or disc material it results in the nerve having less room to exist and function, and the result is a pinched or compressed nerve.

    Pain from this type of compression can be felt at the source in the back or at any point along the path of the nerve. For example if there is compression of the S1 nerve you could feel it in the lower lumbar area or you might just have pain on the outside of the foot/little toe. This narrowing is called "stenosis" and in a report, it is "graded" as follows: minimal, mild, moderate and severe. You will note that the stenosis at L4-5 in the foramina on the right side is judged to be severe. That means that the spinal nerve is being squished almost as much as it can be. Severe stenosis usually means that if the nerve isn't freed at some point, you run the risk of permanent nerve damage.

    You also have lesser amounts of stenosis at L2-3 and L3-4 in the foramen and some curvature of the spine to the left (levo scoliosis).

    You should make an appointment with a spine specialist for a proper evaluation and diagnosis. You most likely need to treat this with something other than pain pills.

     
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