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    Old 05-29-2014, 05:19 PM   #1
    littlebitlarisa
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    Exclamation Mri report deciphering

    Hello there,

    I have recently went in for a mri and am now awaiting my drs appointment. I am going crazy not knowing what this all means. I am a 24 yr old female with spinal bifida occulta. I have had two spinal surgery's. My first was at 3 months to detehter and drain fluid and again for a detether surgery at 17. I am having a reoccurrence of symptoms like before my most recent surgery. Such as Leg weakness, shooting pain, numbness, tightness when bending and bladder issues.

    I am not asking anyone to diagnose as that is for my dr to do but was wondering if anyone could explain some of what I am reading to me.

    Technique:MRI Lumbar spine performed with and without administration of gadolinium using axial and sagittal pre- and post gadolinium T1, sagittal STIR and T2, T2 coronal, and axial T2 sequences.

    MR Contrast 12 CC ProHance IV.

    Result:

    Postoperative changes of multilevel lumbar laminectomies (L2-L5, S1, S2) for prior core detehering. Segmentation anomalies redemonstrated at L5 with posterior wedging of the L5 vertebrae, fusion of the right L4 and L5 articular pillars and hypoplasia of the left superior articular facet of L5. Cord terminus extends to the level of L5 with redemonstation of a AP oriented left parasagital bony/cartilagiouns spur which arises from the dorsal aspect of the upper L4 vertebra extending slightly obliquely to the dorsal sac at L4, compatible with the diastematomyelia. This asymmetrically splits the terminal cord into 2 components, larger present at the right of the midline. A small CSF signal intensity cyst is seen in dorsal to the terminal cord at the L3 and L3-L4 level similar appearance to the prior study. Cord syrinx is slighly increased in sice centered a the level of L2 measuring up to 3 mm greatest transverse dimension. Postgadolinium images demonstrate some enhancement along the dorsal aspect of thecal sac at L4 and also along the lateral and ventral aspect of thecal sac at L5 and S1 level compatible with postoperative changes and epidural scar. Small amount of enhancement also present at the distal aspect of the cord cyst interface which may als be postoperative in nature. Asymmetric thickening of the right-sided terminal nerve roots demontrated at the S! level with associated enhancement could reflect arachnoiditis.

    Susceptibility artifact associated with postoperative changes in the dorsal lumbar soft tissues.

    Impression:
    Status post cord tethering, diastematomyelia, and L5 segmentation anomalies. There is slight increase in distal cord syrinx centered at L2 level.

    Enhancement present along the margins of thecal sac associated with a laminectomes suggesting foci of epidural scar.

    Asymmetric thickening of right-sided terminal nerve roots at S1 suggest arachnoiditis.


    Maybe someone has some of the same stuff on their mri report?

     
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    Old 05-30-2014, 12:29 AM   #2
    gmak
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    Re: Mri report deciphering

    H&i lillarisa, Yes, i have some similar things on my mri report but you poor thing my report is not nearly as involved! I have had adhesive arachnoiditis since 1988 & its pretty advanced according to MRI's, have tethered cord at L3, no syrinx, have had CSF leaks & small cysts, epidural scarring or fibrosis, dura denuded & inside thecal sac from L1 -S1 all my spinal nerves/or cauda equina nerves became swollen, thickened & scarring split nerves apart, pushed CSF out, cut circulation off to spinal nerves & whats left of nerves are now scarred onto my dura or covering of thecal sac & all caused by adhesive arachnoiditis process after i had 4 lumbar laminectomies with alot of dural grafting starting @ age 26. It first showed on MRI as peripheral clumping of nerve roots. 3 spine neurosurgeons told me that if MRI shows spinal nerve clumping, thickening, epidural scarring or fibrosis it is still necessary to be examined to make a definitive diagnosis of arachnoiditis other ARC specialists say spinal nerve clumping on MRI is diagnostic. My arach symptoms are severe constant back pain, neuropathy symptoms mostly in my feet, cramps or charley horses, slight jerking, occasional difficulty in starting bladder emptying but lyrica helps nerve symptoms greatly for me.I would be so happy to help you understand report or share about arach but i am not sure where to start or which part of MRI report you need help deciphering & need some clarification of what you do understand, if you would please? I am so sorry that your symptoms seem to be returning after your surgeries & truly hope that everything is easily fixable to bring you relief! Its really late, early a.m. here now & maybe can be more helpful tomorrow morning! Lol God bless you larisa!

    Last edited by gmak; 06-19-2014 at 05:12 PM.

     
    Old 05-30-2014, 04:45 AM   #3
    littlebitlarisa
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    Re: Mri report deciphering

    Thank you so much for your response Gmak! I went into the mri thinking that with my symptoms that the report would say that I had a tethererd cord again. However I do not see that in the report. It says teathered cord in the "Impression" but before it it says status post which I believe to mean previous condition. But totally not sure on that? What else in the report could cause the symptoms I am having? I do not want another surgery but I cannot function at my job with these symptoms. I am have not seen my neuro since after my last surgery. I guess its time

     
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    Old 05-30-2014, 04:58 PM   #4
    gmak
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    Re: Mri report deciphering

    Hi larisa, The symptoms you are describing are common with nerve compression or neuropathy or arachnoiditis & your MRI is pretty complicated with the congenital issues, previous repairs & problems with the spinal cord but your NS will know, is he the same dr that performed your surgeries?i agree its time to see him if its been seven years & your symptoms are interfering with working, etc. I had my surgeries in the 80's & its amazing how much more can be done to help relief nerve compression & neuropathy now without surgery, meds that really help nerve symptoms, TENS & spinal cord stimulators, PT, epidural steroid injections, nerve blocks, radio frequency ablations etc. & many spine surgeries are minimally invasive now too!

    Last edited by gmak; 06-03-2014 at 09:50 PM.

     
    Old 06-03-2014, 10:11 AM   #5
    littlebitlarisa
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    Re: Mri report deciphering

    Yes she will be the same one that preformed my surgery in 2007. My first surgan from 1989 has since retired and relocated. With my job I am on my feet pretty much the whole time and in a sand arena. I work as a therapeutic riding instructor. I just want to hurry up and get better so I can continue serving those who need the movement of a horse. It has been so beneficial for so many of our clients. Also living my life with a little less pain would be nice.

     
    Old 06-03-2014, 09:58 PM   #6
    gmak
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    Re: Mri report deciphering

    Hi larisa, I understand about wanting to feel better & normal enough to work, help others because before my back got really bad my profession was serving children too, but not on horses! Lol Thats a very special way to help others! When i moved from NS care to pain mgmt it really helped reduce the pain to better functioning, a new normal after the NS's told me there was nothing more to be done surgically. Did you get a NS appt & are you in pain mgmt?

    Last edited by gmak; 06-19-2014 at 04:24 PM.

     
    Old 06-04-2014, 10:00 AM   #7
    littlebitlarisa
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    Re: Mri report deciphering

    I have to get a referral from my primary to go to my neurosurgeon. I see my primary in the morning so hopefully he will get it rolling. I am currently taking gabapentin and ibuprofen to manage my symptoms. Some days are better than others but the last few months I have had some amount of constant pain. The nerve pain seems to be the worst but I have so much numbness in my back and legs that I may be feeling less pain than I really have. For me major pain meds are a last resort. I have a few close family members that have became so addicted to them that it controls their life and I do not want that to happen to me. I understand that it does not happen to everyone and they may be the select few but it still scares me.

     
    Old 06-19-2014, 03:51 PM   #8
    littlebitlarisa
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    Re: Mri report deciphering

    Saw my neurosurgeon today and have surgery set for July 18th. Said surgery would be very similar to my last.

     
    Old 06-19-2014, 06:23 PM   #9
    gmak
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    Re: Mri report deciphering

    Quote:
    Originally Posted by littlebitlarisa View Post
    I have to get a referral from my primary to go to my neurosurgeon. I see my primary in the morning so hopefully he will get it rolling. I am currently taking gabapentin and ibuprofen to manage my symptoms. Some days are better than others but the last few months I have had some amount of constant pain. The nerve pain seems to be the worst but I have so much numbness in my back and legs that I may be feeling less pain than I really have. For me major pain meds are a last resort. I have a few close family members that have became so addicted to them that it controls their life and I do not want that to happen to me. I understand that it does not happen to everyone and they may be the select few but it still scares me.
    Hi larisa, I hope that your surgery goes well & that it relieves all of your symptoms & you can get back to working & helping others with the horses as soon as possible! Im sorry that you are afraid of pain medicine because of seeing bad experiences of others but really now most chronic pain is treated by pain mgmt drs & pain mgmt is not just taking or being addicted to major pain meds & although it can seem scary it can be a Godsend when the pain is constant, severe, chronic, not leaving & surgical repairs no longer an option & the goal is to manage the pain with a combination of treatments, medicines, procedures, PT, tens, spinal cord stimulators & intrathecal pump & so many other modalities that the pain dr tries so that the pain becomes tolerable enough to allow increased functioning but it is not completely relieved & the medications are usually a combination of non steroidal anti inflammatories, anti seizure & anti depressants as adjunct meds, steroidal epidural & trigger point injections & if narcotics are needed the lowest dose that manages the pain is maintained & they are usually timed released, long acting oral meds or patches so that the medicine keeps a steady blood level over the day/ night & theres no feeling of being drugged & while there can be physical dependency several of my drs have said studies have shown that if taken for severe chronic pain addiction risks are very low if not almost non existent. I was 26 when i injured my back very badly & of course we hoped that the surgeries would fix everything & did but then i developed arachnoiditis & the pain kept getting worse & eventually has had to be managed over 3 decades & im so grateful for pain mgmt drs because their skills help make my life livable again. I hope that your surgery works perfectly & you never have back pain again but if ever you do need pain mgmt i hope that this helps with understanding pain mgmt a little & will help allay any fears that you have. God bless you, your surgery & recovery!

    Last edited by gmak; 06-19-2014 at 06:47 PM.

     
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