Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Neurology (Expert Forum)
Back pain
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Back pain
by suluisa, Apr 18, 2006 12:00AM
I recently had an MRI and don't understand it.
Anatomic alignment with normal lumbar lordosis. Mild L3-L4, moderate L4-L5, advanced L5-S1. Type II endplate Modic Changes are present L4-L5, L5-S1. Additionally there is a hemangioma of the L5 vertebral body. Conus ends at L1.
L4-L5 demonstrates a small dorsal annular tear in the left paracentral region with eccentric broad based disc protrusion eccentric to the left contributing to moderate left lateral recess stenosis and mild inferior left neural foraminal narrowing. Additionally there are lesser degrees of right sided neural foraminal narrowing from broad based disc component. The nerve roots appear to escape unimpeded, however.
L5-S1 demonstartes a right paracentral protrusion with a small extrusion extending cephalad along the dorsal aspect of the L5 vertebral body. This results in moderate right lateral recess stenosis and appears to abut the nerve root sleeve on the right to S1-S2 level. There is a mild bilateral neural foraminal narrowing.
Impression: Lower lumbar degenerative disc disease which is advanced at the L5-S1 level with L4-L5 broad based disc ptrotrusion eccentric to the left and right paracentral L5-S1 disc protrusion with a small component extruding cephalad as described above effacing the right lateral recess and appearing to abut the right S1-S2 nerve root sleeve in the lateral recess.
Anatomic alignment with normal lumbar lordosis. Mild L3-L4, moderate L4-L5, advanced L5-S1. Type II endplate Modic Changes are present L4-L5, L5-S1. Additionally there is a hemangioma of the L5 vertebral body. Conus ends at L1.
L4-L5 demonstrates a small dorsal annular tear in the left paracentral region with eccentric broad based disc protrusion eccentric to the left contributing to moderate left lateral recess stenosis and mild inferior left neural foraminal narrowing. Additionally there are lesser degrees of right sided neural foraminal narrowing from broad based disc component. The nerve roots appear to escape unimpeded, however.
L5-S1 demonstartes a right paracentral protrusion with a small extrusion extending cephalad along the dorsal aspect of the L5 vertebral body. This results in moderate right lateral recess stenosis and appears to abut the nerve root sleeve on the right to S1-S2 level. There is a mild bilateral neural foraminal narrowing.
Impression: Lower lumbar degenerative disc disease which is advanced at the L5-S1 level with L4-L5 broad based disc ptrotrusion eccentric to the left and right paracentral L5-S1 disc protrusion with a small component extruding cephalad as described above effacing the right lateral recess and appearing to abut the right S1-S2 nerve root sleeve in the lateral recess.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 25, 2006 12:00AM
As always with these report, they are worded with radiology jargon, as they are meant to be interpreted by other radiologists or physicians - they should provide a second report for patients!
As we get older most of us get 'wear and tear' on our back joints, which this MRI suggests. Modic changes are common age related changes of the vertebral bodies. Hemangiomas are benign blood vessels in the vertebra and are not significant. The conusis the end of the spinal cord and is in the normal position.
the tear is in the disc (the cushion between the vertebra bones), the inside is sort of mushy, so if there is a tear in the cover of the disc, it can squeeze out a bit and make things tighter in the area of the spinal cord and nerve roots. It seems to be making things tighter ('foraminal narrowing', 'stenosis') but does not seem to be compressing the spinal cord or a nerve root although it is 'touching' the S1-2 nerve root.
Ask the doctor who ordered the MRI to interpret this as well as he is the one who knows the clinical question as to why it was ordered in the first place
Good luck
As we get older most of us get 'wear and tear' on our back joints, which this MRI suggests. Modic changes are common age related changes of the vertebral bodies. Hemangiomas are benign blood vessels in the vertebra and are not significant. The conusis the end of the spinal cord and is in the normal position.
the tear is in the disc (the cushion between the vertebra bones), the inside is sort of mushy, so if there is a tear in the cover of the disc, it can squeeze out a bit and make things tighter in the area of the spinal cord and nerve roots. It seems to be making things tighter ('foraminal narrowing', 'stenosis') but does not seem to be compressing the spinal cord or a nerve root although it is 'touching' the S1-2 nerve root.
Ask the doctor who ordered the MRI to interpret this as well as he is the one who knows the clinical question as to why it was ordered in the first place
Good luck
I would say depending on your pain level and how active you are that if you can put off the surgery do it but if you are in pain all the time and have a hard time getting around surgery might be the answer. Take some time to think it over!! I have a feeling they will have me on the table again in the future and I don't look forward to it one bit. Good luck!
I am in constant pain and with the MRI evidencing the herniations, I do not know what the possible other avenues of treatment/relief could be. I think I should go for a second opinion although I do understand the doctor not wanting to do surgery "just yet" in a 38-year old. But I have to have some sort of relief soon or I will end up having a nervous breakdown!!!