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    Old 05-14-2016, 12:25 AM   #1
    jakesRSA
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    Help understand MRI results

    Good day all.

    My wife went for an MRI a year after back surgery.

    Please help me understand what the comments on the report mean. Below is the comment from the report.

    MRI Lumbar spine without contrast:
    L2-L4 mild disco path with no significant spinal canal stenosis or nerve root truncation. L5-S1 annulus tear fibrosis with no spinal stenosis or nerve root truncation. In the one to four facet and ligament hypertrophy with left L2-L3 facet synovitis.
    At the site of surgery, fibrosis with located fluid collection, no communication with subarachnoid space to suggest a pseudo meningocele.

    MRI Cervical spine without contrast:
    Loss of Lords is due to muscle spasm.
    C5-C6 annulus tear fibrosis with disk herniation, abutting the left C5 ventral exiting nerve root in the neural foramina.
    C6-C7 left paracentral disk herniation. No nerve root truncation.

    I would really appreciate any help.

    Greetings from South Africa.
    Jakes

     
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    Old 05-14-2016, 06:45 AM   #2
    teteri66
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    Re: Help understand MRI results

    Welcome to the board. What type of surgery did your wife have and at what location? What are her current symptoms?

     
    Old 05-14-2016, 07:12 AM   #3
    jakesRSA
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    Re: Help understand MRI results

    She had an L5-S1 fusion in 2003. The operation was great success.Was in motor vehicle accident in 2009.

    Last year 2015 she started limping left leg. Took her to another orthopedic surgeon, diagnosed with 2 truncated nerves L4-L5 and L5-S1 levels. Doctor performed further posterior fusion L4-L5 with a cage and laminectomies.

    1 year later she is suffering from terrible back spasms and the pain had not really dissipated. She also started complaining of numbness in left hand that's why MRI included the neck this time.

    The surgeon said after this MRI that the prosteses is in place but nerve damage had not really improved.

    Both her neck and back he did not recommend further surgery. Said to use heat and paracetamol for pain.

    We are hoping for another child but with the back complications the surgeon said it is your choice as my wife will have severe pain.

     
    Old 05-14-2016, 04:15 PM   #4
    teteri66
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    Re: Help understand MRI results

    It would appear that at least part of her pain is coming from the facet joints. These are the synovial joints that are adjacent to the discs and link one vertebra to the next. Along with the discs, they are what allow the spine to bend, twist and have movement, and as such, are subject to arthritic and degenerative change. Being a synovial joint, they are fluid-filled.

    The report indicates that at L2-3 there is an inflammation of the lining of the facet joint on the left side. Is your wife's pain along the front outside or does it run down the back of her leg?

    I must say, the language of the report is different from what is used in the US so I am a little less confident in my interpretation. The reason, I assume, the surgeon said no surgery is because there isn't any obvious compression of nerves and the issues mentioned pertain to arthritic facet joints, for which treatment is anti-inflammatories and things that make the patient more comfortable....like heat.

    Since your wife has implants in lumbar spine and this MRI was done without contrast, there is a possibility that something could have been missed. If her pain is not manageable, I would suggest consulting with a different spine surgeon for another opinion.

    I would also speak with an obstetrician who specializes in high risk pregnancies about what a pregnancy would be like with your wife's issues. I know people who have successfully carried to term who had much worse issues...or, at least so it would appear from this report!

    Regarding the cervical MRI report, there is a disc herniation at C5-6 that includes a tear in the outer layer of the disc. This sometimes can be very painful as there is a chemical reaction with nerve endings located in the annulus. Also, this disc material is coming in contact with the left C5 spinal nerve root...not compressing it but likely causing irritation.

    At C6-7 the disc is herniated just to the left of center...no indication of the size of the herniation, but it does not appear to involve any nerve roots.

     
    Old 05-15-2016, 10:13 AM   #5
    jakesRSA
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    Re: Help understand MRI results

    Thank you so much!

     
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