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    Old 05-24-2012, 07:40 AM   #1
    jess789
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    Hi, I'm new with MRI results and alot of questions.

    Hi my name is Jessica. I found this board while doing a search on my MRI results. I'm confused and not sure what to think. I've had back problems for a couple of years now but Dr's have told me repeatedly that i'm too young (i'm about to turn 30) to have any problems. They have brushed me off saying it's in my head or a sprain. I finally got a dr to listen to me and send me for an MRI.

    He did tell me after looking at my back that he believes I have a mild case of scoliosis. It runs in my family and there is an obvious curve in my spine. I had 3 MRI's for the cervical, thoracic & Lumbar spine. Can anyone tell me what some of the terminology means so I have a heads up before I go to the dr. I do have pain and numbness between my shoulder blades, pain at my neck, pain in lower back, sciatica pain and alot of numbness and weakness in my legs and feet.

    MRI Results:

    EXAM: MRI lumbar spine without contrast.
    PREVIOUS FOR COMPARISON: None.
    INDICATION: Low back pain with bilateral hip radiculopathy.
    TECHNIQUE: Noncontrast sagittal and axial Tl and T2-weighted MR imaging performed of lumbosacral spine on 0.3
    Tesla AIRIS Elite open MRI system.
    FINDINGS: Five lumbar-type verlebral bodies are assumed. Sagittal alignment normal with no vertebral body height loss
    or listhesis. Conus terminates at L1 .
    L1-L2, L2-L3 and L3-L4: Normal disc signal and height. No canal or foraminal stenosis.
    L4-L5: Loss of disc signal. Minimal concentric disc bulge. No canal or foraminal stenosis.
    L5-S1: Normal disc signal. Mild concentric disc bulge with no canal or foraminal stenosis.
    IMPRESSION:
    1. Very rnild early degenerative disc disease with mild bulge at L4-L5 and L5-SI. No canal or foraminal stenosis.

    EXAMINATION: MRI thoracic spine without gadolinium S/21/2012
    COMPARISON: None
    INDICATION: 29 year-old female complaining of mid back pain.
    TECHNIQUE: Multiplanar multisequence MR imaging of the thoracic spine was performed without gadolinium
    utilizing standard protocol. Examination was performed on a 0.3 Tesla open Hitachi MRI scanner.
    FINDINGS: Vedebral body height, signal intensity and alignment are preserved throughout the thoracic spine.
    Disk spaces are preserved without evidence significant bulge, protrusion or efrusion. Cord signal intensity is
    unremarkable without evidence myelopathic change.
    IMPRESSION:
    Unremarkable MRI thoracic spine.
    This one does confuse me cause the dr said he can feel and actually see a curve in my spine thats obvious to indicate scoliosis. According to this I don't but even looking at the MRI pics you can see the curve. But I don't know i'm not a Dr.

    EXAM: MRI cervical spine without gadolinium S/21/2012
    COMPARISON: None
    lNDlcATloN: 29 year-old female complaining of neck pain and numbness in her fingers for the past 4 years.
    No response to conservative management.
    TECHNIQUE: Multiplanar multisequence MR imaging of the cervical spine is performed without gadolinium
    utilizing standard protocol. Examination is performed on a 0.3 Tesla open Hitachi MRI scanner.
    FINDINGS:
    There is mild loss of the normal cervical lordosis with relative kyphosis centered at C4. Otherwise, vertebral body heights, signal intensities and alignment are preserved in the cervical spine. Disk signal intensities demonstrate multilevel degeneration and dorsal disk-osteophyte complexes, please see segmental findings below for full discussion. Cord signal intensity is unremarkable without evidence myelopathic change. Visualized posterior fossa structures unremarkable.
    Segmental findings are as follows:
    C2/3. Unremarkable without evidence significant foraminal or central canal stenosis.
    C3/4: Mild disc osteophyte complex is present composed predominantly of a mild broad-based disc bulge. No
    significant foraminal stenosis. Mild central canal stenosis with effacement of the thecal sac but no evidence of
    cord abutment, cord displacement, cord flattening or cord signal abnormality.
    C4/5. Mild disc osteophyte complex is present composed of both uncovedebral hypertrophic change and a mild
    broad-based disc bulge. No significant foraminal stenosis. Mild central canal stenosis with effacement of the
    thecal sac but no evidence of cord abutment, cord displacement, cord flattening or cord signal abnormality.
    C5/6: Moderate disc osteophyte complex is present which is predominantly leftward and orientation. This
    produces mild right and mild left foraminal stenosis and mild central canal stenosis with effacement of the thecal
    sac but no evidence of cord abutment, cord displacement, cord flattening or cord signal abnormality.
    C6/7: Mild disc osteophyte complex is present composed of a mild broad-basedisc bulge. No significant
    foraminal or central canal stenosis.
    C7/T1: Unremarkable without evidence significant foraminal or central canal stenosis.
    IMPRESSION:
    1. Mild multilevel degenerative disc disease throughout the cervical spine as discussed in detail above. No evidence myelopathic change.

    Any input would be greatly appreciated. I'm sure you guys do this all the time and I'm sure mine is nothing compared to what some of you have. I just want to feel better and be able to do more than I can right now. I have 4 kids and can't do much with them without winding up in alot of pain and barely being able to move. Thank you and I hope everyone has a good day

     
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    Old 05-24-2012, 09:02 AM   #2
    pebblebeach2
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    Re: Hi, I'm new with MRI results and alot of questions.

    Welcome Jessica to the Board.

    First, let me start with this. It infuriates me when a patient is told you are told you are too young or it's all in your mind. You know how you feel and don't let anyone tell you differently. My spine problems started when I was 35 and I will be 59 next month and still having issues. Just briefly I have been thru 7 spine surgeries on the cervical - neck - and lumbar - low back regioins. Which included putting harring rods on my most of my spine due to the severity of the problems.

    I am not sure if I missed this in your post, but who are you treating with for your spine issues. My opinion is that you should be seeing either an orthopedist or someone that is a neurologist or surgeon that specializes in spine related issues and is board certfied in this area as well. Also I feel personally that they should be affiliated with a teaching hospital.

    Part of your report refers to stenosis. This means that there is narrowing on the nerves from the spine. The stenosis can be on the central canal. The centeral canal is like a straw where all the nerves from the brain run thru a central location. The foramen refers to the nerves that exit the spine. The nerves that exit the spine will deal with either lets say your hands and arms or depending on the level with the nerves that go to your legs and so on. It says no stenosis which is a good sign in that the nerves in the central canal or where they are exiting have not been affected yet.

    If I read the cervical MRI right there is some stenosis. So there appears to be some pressure being placed on the nerves.

    there was a reference to disc bulges in the report. Think of the spine this way. At each level there is this cushion whichi soft in nature. It should be in a certain position if things are normal. But when it bulges it is slightly out of position and protrudes from the normal position. there are bulges then there are herniations. Herniations are more severe then bulges in the degree that they are out of alignment from the spine.

    The report says degenerative changes. This means that changes are occuring in your spine over time. We all will experience changes to our spines over time, That is normal. It occurs from wear and tear of daily living. This is compared to it being caused by some type of trauma such as an automobile accident.

    Just a note, I am giving an overall impression of what I am seeing from your report without giving too much details at this point. It can be overwhelming to say the least. I am giving you what I see as to what stands out at the moment. I am sure I could find more if I reread your report as well. It does appear that you have issues in the neck.

    Again who ordered the MRI? your primary doctor or a specialist? I suggest seeing a specialist that deals with spine issues. Has physical therapy been suggested? Any medication been prescribed?

    Hope I have given you some insight. Any questions please ask. You will find a wealth of knowledge from the people that are part of this board.

    Let us know how you make out.

    Allan

     
    Old 05-24-2012, 09:28 AM   #3
    jess789
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    Re: Hi, I'm new with MRI results and alot of questions.

    Hi Allan, thanks so much for your input. Right now I am only seeing my primary dr and he's the one that ordered the MRI. He was concerned because of the tingling and numbness i've been experiencing. I am on some meds temporarily that have been helping some. Right now i'm on Norco 7.5-325mg, Soma 350mg, and Diclofenac 75mg. I am assuming he's going to refer me to an orthopedist but I'm not sure yet. I have been told my neck is the worst by a chiropractor. But I had to quit seeing him because I was hurting more after adjustments than before and would wind up completely laid up in bed. Plus my primary said that with scoliosis a chiropractor is a big no-no.

    I did physical therapy a few years ago and it didn't help. But slowly but surely the pain and numbness has gotten worse. I have never been in a car accident to cause trauma or anything like that so i'm not sure why my neck is so bad. I was thrown off alot of horses as a teenager and a few times it was pretty bad. I'm glad the MRI finally showed its not in my head, but now I wonder if I'm gonna be told that it's not bad enough to cause the pain and numbness i've been having. There have been times I'm just standing there and my legs go completely weak and numb and I feel like i'm gonna fall. It almost feels like my legs aren't even there. I'm just not sure what to think.

    I was working as a housekeeper at a nursing home but had to quit because it was so physically demanding and my back would feel as if it was trying to lock up on me and I could hardly move when I would come home from work. I also have fat herniations in the hip area and have been told that those can entrap nerves as well. Would someone like me just normally go through physical therapy? What treatment options are there? I was reading that I guess I have some bone spurs in my neck. How do they treat those?

    Thanks so much for answering questions for me, I really appreciate it.

     
    Old 05-24-2012, 10:10 AM   #4
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    Re: Hi, I'm new with MRI results and alot of questions.

    Jessica:

    The medication that you are on I can't comment on. While I've been on a lot of medications over the years, the ones you are on I have never tried.

    For me I am currently on Hydrocodone for pain and Tizanidine for a muscle relaxant. The hydrocodone is considered a narcotic and is heavy duty stuff. As I mention I was thru 7 surgeries and they are afraid to touch me again, espcially in the neck.

    As to chirorpractors I never tried one because I didn't feel that they would benefit me in the long run.

    I think I had bone spurs and can't recall if they were taken care of surgically or not. I have had so much done that I can't recall everything.

    My medical history included herniated discs in the lumbar area; stenosis in the neck and the worst was "flatback syndrome" in the lumbar were because of the way the discs were I could not stand up straight for 14 months thus I required harrington rods to keep the spine in proper position. Then I had kyphosis of the neck and couldnt straighten my neck out properly anda gain required surgery with harrington rods to keep my neck straight. This surgery was a 12 hour surgery done over a 2 day period. Now my neck is showing weakness of the spine thus causing pain in the neck; radiating pain etc. and I do have severe nerve damage in the neck and low back. So surgery for me in the future is questionable since it is dangerous.

    I really think you need to push your primary doctor to get you to either an orthopedic surgeon or neurosurgeon for proper evaluatioin and treatment of the spine issues. Thats their specialty and the ones that should really address the issues at this point in time since they did find concerns in the MRI.

    Physical therapy may or may not help. Medication may or may not help. It's a matter of finding the right medication that works for you.

    Are you a candidate for surgery? That only can be answered by the orthopedist or neurosurgeon.

    I don't know what type of insurance you have. But my belief from past experience is get to the best doctor that you can for treatment.

    I currenlty do pool therapy. They always said pool or swimming is great exercise for the back. But ask your doctor if thats what he feels you should do.

    Good luck and keep us posted. WE are here for you.


    Allan

     
    Old 05-24-2012, 11:09 AM   #5
    jess789
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    Re: Hi, I'm new with MRI results and alot of questions.

    Thank you again for your input. The norco I'm on is hydrocodone. Norco is just brand name I guess. I did call my dr's office and they said they got the results and he looked at them and wants to see me to go over them. So I have an appt June 4th to see him. I will talk to him then about going to an orthopedist or specialist. Regardless I know my insurance doesn't require a referral for an orthopedist as I had to see one about 6 months ago to remove a ganglion cyst from my wrist. So I can just make the appt myself if need be. Thanks again and I guess I'll just have to wait and see what happens.

     
    Old 05-24-2012, 11:17 AM   #6
    pebblebeach2
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    Re: Hi, I'm new with MRI results and alot of questions.

    Good luck. Unfortunately its always a waiting game at times to see the doctors; to get the test results etc. I've been doing thsi for 24 years so I know the routine.

    Going over the results with your primary doctor is fine. Let him have his input. But dont forget there is a reason for specialists. Let the specialist be the one to really guide you on what the proper treatment is for your problems. And if necessary 2nd opinions are always an option especially if surgery is recommended.

    Let us know what happens after you see your primary. Good Luck.

    allan

     
    Old 05-24-2012, 11:22 AM   #7
    TaoZen108
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    Re: Hi, I'm new with MRI results and alot of questions.

    pebblebeach and jessconnor,
    wow you all sound like me..... Are you getting better ? it helped me reading your stuff..
    yeah those back problems really are "a pain in the back".

     
    Old 05-24-2012, 11:31 AM   #8
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    Re: Hi, I'm new with MRI results and alot of questions.

    Tao:

    I wish I could say I was getting better. My spine issues started in 1988. Here it is 24 years later and I am still dealing with issues.

    I saw my neurosurgeon yesterday. I have myelomalacia of the cervical spine which means weakening. You can actually see on the MRI films a C5/6 levels that there is a narrowing on the spinal canal. Thus I have radiating pain mostly into the left shoulder, weakness in my arms, a crushing feeling at times of the spine. I also have lumbar issues. I have numbness in my left leg and now its going into the right leg. Some of it may be spinal in nature and some may be due to my diabetes. Thus I have difficulty walking long periods of times or sitting for a long time. Again my arms feel weak at times and the surgeon has noticed diminished capacity neurologically since I have been seeing him for the past 7 years or so. So things are progressively getting worse.

    I do lose my balance at times, havent fallen yet.

    Told surgery on me would be an issue so living on narcotics to get thru the day. some days are better then the others. Never know day to day as to how I am going to feel.

    Taking each day as it comes at this point in time.

     
    Old 05-24-2012, 11:37 AM   #9
    jess789
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    Re: Hi, I'm new with MRI results and alot of questions.

    I actually had one dr tell me that i've had 4 kids, and that's hard on your body including back problems so I needed to just deal with it. It's amazing to me how dr's are supposed to improve your quality of life yet alot of them just seem to judge you or guess and brush you off so they can quickly get to the next patient. So sometimes I wonder what's the point. Why be a dr. if your not really there to help people.

     
    Old 05-24-2012, 01:08 PM   #10
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    Re: Hi, I'm new with MRI results and alot of questions.

    Jessica - Your MRI's all look fine. Really. Unless the radiologist is insane, blind, or got the wrong images, there's nothing on any of them that requires attention, or even would be likely to cause more than mild symptoms, if any...

     
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    Old 05-24-2012, 01:10 PM   #11
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    Re: Hi, I'm new with MRI results and alot of questions.

    Through the years I've come across a lot of bad doctors and a lot of good doctors. So I have become very picky on who treats me. If I start getting the sense that they are not the doctor for me, then my attitude is NEXT ... I'll find someone else.

    A lot of doctors look good on paper as to where their education is from and what their specialities are.

    But what is important to me in a doctor is one that listens to what you are saying and you aren't rushed. Yes, I realize that they are busy but don't brush me off either.

    There are some doctors that I will swear by because they are the type of doctor that I am looking for.

    For example, 5 years ago they found a mass on my pancreas. The question was whether to operate or not. My gastro doctor referred me to a surgeon who said no. But my gastro doctor felt that surgery had to be done so he referred me to another doctor at another hospital surgery was done.

    I feel my gastro doctor saved my life for going to bat for me. He truly felt surgery was the only solution and I agreed with him.

    This doctor is knowledgable, easy to communicate with, caring etc. The list goes on and on.

    So to this doctor I say thank you for being the doctor that you are and for saving my life.

    So keep searching there are good doctors out there.

     
    Old 05-24-2012, 03:29 PM   #12
    jess789
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    Re: Hi, I'm new with MRI results and alot of questions.

    Webdozer, Thank you for your reply. So do I need to be looking elsewhere other than the spine that would cause the pain, weakness, tingling and numbness? I know my symptoms are not severe but they are bad enough to affect my day to day activities and I just want to get to the source of the problem. So if according to the MRI's I should have very little to no symptoms then it has to be coming from somewhere else right?

     
    Old 05-24-2012, 03:45 PM   #13
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    Re: Hi, I'm new with MRI results and alot of questions.

    Have you been checked for diabetes or ms? Have you had any blood work at all done? If so, what did they test for? I have to agree with webdozer (and I'm no expert), nothing screams out.

    Last edited by kenzibenzi; 05-24-2012 at 03:46 PM.

     
    Old 05-24-2012, 04:03 PM   #14
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    Re: Hi, I'm new with MRI results and alot of questions.

    << So do I need to be looking elsewhere other than the spine that would cause the pain, weakness, tingling and numbness? >>

    That's my opinion, although (1) you must know that I'm an amateur and (2) I'm basing my opinions on the radiologist's report, which always could be in error. Still, look at the adjectives... "unremarkable", "minimal", "mild". These are the first three steps in what you might call a severity ladder. "Unremarkable" means, "I see nothing worth noting". "Minimal" means, "I see something, but just barely". "Mild" means, "clearly there, but not serious". The next two steps are "moderate' (this MIGHT be problematic) and "severe" (fix this!).

    I'm not used to seeing reports on 29-year-olds, so I don't know how you compare to your peers, but my impression is that you are starting to have problems, that may be actionable by your 40's. I'd suggest you do what I wish I could go back and do, which is exercise and stretch and practice good posture at all times. There's a ton of information on all that.

    A couple of specific notes....


    << C3/4: Mild disc osteophyte complex is present composed predominantly of a mild broad-based disc bulge. No significant foraminal stenosis. Mild central canal stenosis with effacement of the thecal sac but no evidence of cord abutment, cord displacement, cord flattening or cord signal abnormality. >>

    Foraminal Stenosis is when something (a disk bulge or bone spur) starts to block the foramen, which is the opening through which your peripheral nerve leaves the spinal cord.

    Effacement of the Thecal Sac means that this disk bulge has pressed back into the spinal canal, which consists of an outer membrane called the thecal sac, spinal fluid inside that, and the spinal cord inside the fluid. "Effaced", in this context, means that this disk bulge has pressed on the thecal sac and pushed away the spinal fluid on the front side of the cord. It has not yet affected the cord, according to the radiologist, but it is threatening to do so. The spinal fluid supplies a "margin for error", and you are losing that.



    << C5/6: Moderate disc osteophyte complex is present which is predominantly leftward and orientation. This produces mild right and mild left foraminal stenosis and mild central canal stenosis. >>

    At this level, the foramina on both sides are starting to be narrowed ("stenosis"). If this continues (and it probably will) the C6 nerves will eventually be affected.

    Last edited by WebDozer; 05-24-2012 at 04:07 PM.

     
    Old 05-24-2012, 04:34 PM   #15
    jess789
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    Re: Hi, I'm new with MRI results and alot of questions.

    Kenzibenzi, I had blood work about a year ago to check arthritis. He said it came back just under the level to be concerned so he said nothing to worry about. Diabetes does run on my dads side. My aunt has it and my dad was diagnosed with it about 6 months ago but passed away 4 months ago. He was 52. But both of them weren't diagnosed till later in life. And I've never been checked for MS. Webdozer again thank you, I'm trying to catch this early instead of later on. I've managed for the last 4 years until about 6 months ago. Thats when it started affecting me daily.

    No falls or accidents. Most days I go to bed and can't sleep because my sciatica is so bad. I get muscle spasms in my back just about everyday. My pain comes from my neck, between shoulder blades, lower back and sciatica. The chiropractor took xrays and said that the curve in my neck was off like -37 degrees, one shoulder is higher than the other, one hip is higher than the other, he also showed me 2 curves in my thoracic spine on the xrays and my pelvis is torqued forward on the left side. It seems like the xrays and MRI conflict themselves and even what the dr said. The dr himself looked and felt down my thoracic spine and said I had an obvious curve and he felt I had mild scoliosis but yet the mri says my alignment is fine on the thoracic. I don't know, I'm just rambling now cause i'm confused so please forgive me for that.

     
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