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MRI Resulta
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MRI Resulta

I have an appointment with my doctor in the near future. Before I see him I would like someone to help me understand the results of two recent MRI's; Thoracic Spine w/o contrast and Lumbar Spine w/o contrast -  I have pain in my lower back and at time down my legs. At times I can also have pain in my chest that feels like I'm having a heart attack.  I travel most every week on planes for business reasons.  I've done this for close to 20 years.  If I should continue to travel will this cause my back to become worse.  

Whatever is wrong with my back causes a lot of pain. Should it? Or, do I just have a low tolerence to pain?  I haven't missed any work in years due to the condition of my back.  However, the pain seems to be getting worse.  Maybe it's just because I'm older (58)?

THORACIC:

FINDINGS: There is a mild dextroscoliosis centered near T8.  There is chronic 20% anterior wedging of T8. There is straightening from T4 through T7. Disc degeneration is mild to moderate at T8-9 through T10-11 with narrowing, endplate irregularity and prevertebral spondylosis.  Disc degeneration is mild with prevertebral spondylosis at T6-7 and T7-8. Additional mild degenerative changes are present diffusely. No significant focal vertebral marrow pathology is seen.

T6-7 demonstrates a mild eccentric disc bulge to the left.  No spinal cord flattening or centeral stenosis.  No foraminal stenoisi.
T7-8 demonstrates a mild broad disc bulge. No spinal cord flattening or central stenosis. No foraminalo stenosis.
T8-9 demonstrates a moderate disc protrusion to the left with mild to moderate spinal cord flattening without central stenosis.  Foraminal stenosis is not significant.
T9-10 demonstrates a mild to moderate broad disc bulge.  A small component of extrusion extends slightly below the T10 superior endplate near the midline.  This abuts but does not appear to flatten the spinal cord.  No central canal stenosis.  Foraminal stenosis appears mild on the right.
T10-11 demonstrates a small left paramedian disc protrusion without spinal cord flattening or central stenosis.  No foraminal stenosis.
T11-12 demonstrates a mild broad disc bulge with asymmetry to the right.  There is mild hypertrophic facet degenerative joint disease on the left.  No central canal stenosis or foraminal narrowing.
The remaining thoracic discs do not show evidence of significant bulge, protrusion or extrusion.
The thoracic cord has a smooth contour and is without focal atrophy, edema or myelomalacia. No mass.

IMPRESSION:
1.  Mild dextroscoliosis centered near T8.  Chronis 20% anterior wedging of T8.  Disc degeneration is mild to moderate at T8-9 throught T10-11.
2.  T8-9 mild to moderate spinal cord flattening to the left without stenosis.
3.  T9-10 disc bulge and small central extrusion abutting without flattening the spinal cord. Mild right foraminal stenosis.

LUMBAR SPINE:

FINDINGS:  There is miold exaggeration of the lumbosacral lordotic curve from L4 through S1.  THere is a mild dextroscoliosis centered near L3.  Vertebral heights appear generally preserved.  There is mild to moderate degenerative disc disease and prevertebral spondylosis from T12-L1 through L3-L4.  Disc degeneration is mild at Lr-L5 and L5-S1.  Small Schmorl's nodes are present at T11-T12.  

There is mild reactive marrow edema adjacent to the endplates posteriorly at L2-L3.

T12-L1 demonstrates a mild foraminal disc protrusion to the right.  Foraminal stenosis is mild on the right.  No central canal stenosis.
L1-L2 demonstrates a mild broad disc bulge.  No hypertrophic facet DJD or central canal stenosis.  Foraminal stenosis is not significant.  
L2-L3 demonstrates a mild to moderate broad disc bulge with asymmetry into the left neural foramen.  Facet DJD is mild bilaterally, greater on the left.  Foraminal stenosis is mild to moderate on the left and mild on the right.  There is mild to moderate left lateral recess stenosis near the left L3 nerve root.  No central cnal stenosis.
L3-L4 demonstrates a mild to moderate broad disc bulge.  There is a small central disc protrusion with a peripheral annular tear.  Facet DJD is mild bilaterally.  Foraminal stenosis is mild on the left.  There is mild left lateral recess stenosis near the left L4 nerve root.  No central canal stenosis.
L4-L5 demonstrates a mild to moderate disc bulge.  Facet DJD is mild on the left and mild to moderate right.  Foraminal stenosis is mild on the left and mild to moderate on the right.  THere is mild lateral recess stenosis bilaterally near the L5 near roots.  No central canal stenosis.
L5-S1 demonstrates a mild broad disc bulge with a central peripheral annular tear.  Facet DJD is mild bilaterally.  No central canal stenosis or foraminal narrowing.

IMPRESSION:
1.  Mild lordotic exaggeration from L4 through S1; mild dextroscoliosis centered near L3; mild to moderate degeneraive disc disease and prevertebral spondylosis from T12-L1 through L3-L4, all stable.  mild reactive marrow edema posteriorly at L2-L3.
2.  T12-L1 mild right foraminal stenosis.
3l L2-L3 mild to moderate left lateral recess stenosis near the left L3 nerve root as well as mild to moderate left and mild right foraminal stenosis.
4.  L3-L4 mild left lateral recess senosis near the left L4 nerve root and mild left foraminal stenosis.
5. L4-L5 mild left lateral recess stenosis bilaterally near the L5 nerve roots as well as mild left and mild to moderate right foraminal stenosis.
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Avatar_m_tn
!st I'll give you a list of terms, so you'll understand what the report's talking about.

Spine Terminology

Disc Bulge: General pushing out of a spinal disc, extending the disc from its normal position. Considered a normal occurrence with age.

Broad Disc Bulge: The term “broad based” simply refers to the size of the actual bulge or herniation. When the size of the herniation is 25% to 50% of the total disc circumference, the disc is called broad based.

Disc Protrusion: is a herniated disc in which the disc tissue has protruded beyond the disc space but is contained within intact annulus. In other words it hasn’t ruptured.

Degenerative Disc Disease: is not really a disease but a term used to describe the normal changes in your spinal discs as you age.

Spondylosis: also known as spinal osteoarthritis is a common degenerative joint disease that is due to aging and time related wear and tear on the vertebrae (bones) of the neck and back.

Spinal Canal Stenosis: The spinal canal is the space inside the lower spine that carries nerves to the various parts of your body. It’s narrow, over time bone and tissue around it can narrow it further. This narrowing is called stenosis. Some things that can cause it are disc bulges/herniations bone spurs/arthritis and ligament thickening.

Facet joints: Joints of the spine that connect all of the vertebrae and allow coordinated movement of the vertebral column.

Facet arthritis: Degeneration of facet joint cartilage and hypertrophy of the bone forming the joint.

Foraminal Stenosis: At every level of the spine the nerves will exit through a small canal. This canal is called the foramen or foraminal canal. Foraminal stenosis is a narrowing of this canal, usually by a disc bulge/herniation or bone spurs.

Neural foramen: A small canal in which the nerves exit the spinal canal at each level. There is a right and left foramina at each level.

Thecal sac: encases the spinal cord and contains fluid to protect and feed the nerves. It is composed of dura mater and arachnoid mater.

Schmorl's nodes: are defined as herniations of the intervertebral disc through the vertebral end-plate.  They may or may not be symptomatic,

http://www.med.nyu.edu/hjd/hjdspine/education/glossary/definitionlist.html


THORACIC:

You have a very mild form of scoliosis, which is a lateral curve of the spine, because of this slight curve the vertebra at T8 is not perfectly in line, over time vertebra in situations like this will develop a wedge shape, yours is only 20% so its very mild and its chronic, meaning that it’s something that developed over a long period of time. Your lower thoracic does show mild to moderate Degenerative Disc Disease, and other changes.

T6-7 and T7-8: you have disc bulges at these levels, but they don’t seem to be causing any problems.

T8-9: Here you have a little more serious disc protrusion, which is mild to moderately compressing your spinal cord. Foraminal stenosis is not significant

T9-10 At this level you have a disc bulge that’s touching, but not compressing the cord. Mild right foraminal narrowing.

T10-11 Disc bulge at this level, doesn’t appear to be causing any problems

T11-12 mild broad disc bulge and mild facet hypertrophy. (It’s explained in the terminology)

LUMBAR SPINE:

You have a mild exaggeration of the lordotic curve (the natural curve we have in our backs) Mild to moderate age related DDD and spondylosis. And small Schmorl’s nodes at T11-12 (see terminology)

There is mild reactive marrow edema adjacent to the endplates posteriorly at L2-L3.

The bone-marrow edema is a common finding in osteoarthritis and RA; it’s a protective reaction of the body in response to an injury or stress. In simple terms, bone marrow edema means there is fluid within the bone marrow.

T12-L1 Disc protrusion mildly narrowing the foramina on the right side
.
L1-L2 mild broad disc bulge, mild foraminal narrowing
  
L2-L3 mild to moderate broad disc bulge into left foramina. Mild Facet Degenerative Joint Disease, Mild to Moderate narrowing of lateral recess (an area on the side of the spinal canal that nerves travel) near L3 nerve root, probably from the facet DJD

L3-L4 mild to moderate broad disc bulge.  There is a small central disc protrusion with a peripheral annular tear (tear in the outer ring of the disc) Facet DJD is mild bilaterally (both sides).  Foraminal stenosis is mild on the left.  There is mild left lateral recess stenosis near the left L4 nerve root.  

L4-L5 demonstrates a mild to moderate disc bulge.  Facet DJD is mild on the left and mild to moderate right.  Foraminal stenosis is mild on the left and mild to moderate on the right.  There is mild lateral recess stenosis bilaterally near the L5 near roots.  No central canal stenosis.
L5-S1 demonstrates a mild broad disc bulge with a central peripheral annular tear.  Facet DJD is mild bilaterally.  No central canal stenosis or foraminal narrowing.

The pain you have in your chest is probably from some of the problems you have in the T-spine, In particular at T8-9 you have some cord compression form a disc protrusion and at T9-10 the bulge is supposedly just touching it. This can generate a lot of pain and cause neurological problems like leg weakness. You definitely need to discuss this area with the Doctor; the concern is that it could get worse. The other thing is the foraminal stenosis; you might have a nerve that’s being pinched. The report states that it’s not significant or mild, but that doesn’t necessarily reflect reality, MRI reading is very subjective and the Surgeons generally look at the films themselves and come up with their own conclusions.

The pain in your low back is probably being influenced by a variety of factors, including your disc degeneration and facet joint problems. The pain in your legs, foraminal stenosis i.e. pinched nerves. Of concern, nerve roots at L3,L4 and L5, the report states that their not currently being pinched but this needs to be confirmed, and also you want to ask about the chances that the stenosis will eventually cause problems if nothing’s done.

Should what’s wrong with your back cause a lot of pain? Yes and I doubt if it has anything to do with low pain tolerance. Some of it is natural aging, but there are some legitimate concerns here.

As far as your activity, I wouldn’t play football right now if I was you, but aside from that you really need to discuss this with your Doctor.

Let us know how your appointment goes and what he/she recommends.


Take Care
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2 Comments Post a Comment
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Avatar_m_tn
!st I'll give you a list of terms, so you'll understand what the report's talking about.

Spine Terminology

Disc Bulge: General pushing out of a spinal disc, extending the disc from its normal position. Considered a normal occurrence with age.

Broad Disc Bulge: The term “broad based” simply refers to the size of the actual bulge or herniation. When the size of the herniation is 25% to 50% of the total disc circumference, the disc is called broad based.

Disc Protrusion: is a herniated disc in which the disc tissue has protruded beyond the disc space but is contained within intact annulus. In other words it hasn’t ruptured.

Degenerative Disc Disease: is not really a disease but a term used to describe the normal changes in your spinal discs as you age.

Spondylosis: also known as spinal osteoarthritis is a common degenerative joint disease that is due to aging and time related wear and tear on the vertebrae (bones) of the neck and back.

Spinal Canal Stenosis: The spinal canal is the space inside the lower spine that carries nerves to the various parts of your body. It’s narrow, over time bone and tissue around it can narrow it further. This narrowing is called stenosis. Some things that can cause it are disc bulges/herniations bone spurs/arthritis and ligament thickening.

Facet joints: Joints of the spine that connect all of the vertebrae and allow coordinated movement of the vertebral column.

Facet arthritis: Degeneration of facet joint cartilage and hypertrophy of the bone forming the joint.

Foraminal Stenosis: At every level of the spine the nerves will exit through a small canal. This canal is called the foramen or foraminal canal. Foraminal stenosis is a narrowing of this canal, usually by a disc bulge/herniation or bone spurs.

Neural foramen: A small canal in which the nerves exit the spinal canal at each level. There is a right and left foramina at each level.

Thecal sac: encases the spinal cord and contains fluid to protect and feed the nerves. It is composed of dura mater and arachnoid mater.

Schmorl's nodes: are defined as herniations of the intervertebral disc through the vertebral end-plate.  They may or may not be symptomatic,

http://www.med.nyu.edu/hjd/hjdspine/education/glossary/definitionlist.html


THORACIC:

You have a very mild form of scoliosis, which is a lateral curve of the spine, because of this slight curve the vertebra at T8 is not perfectly in line, over time vertebra in situations like this will develop a wedge shape, yours is only 20% so its very mild and its chronic, meaning that it’s something that developed over a long period of time. Your lower thoracic does show mild to moderate Degenerative Disc Disease, and other changes.

T6-7 and T7-8: you have disc bulges at these levels, but they don’t seem to be causing any problems.

T8-9: Here you have a little more serious disc protrusion, which is mild to moderately compressing your spinal cord. Foraminal stenosis is not significant

T9-10 At this level you have a disc bulge that’s touching, but not compressing the cord. Mild right foraminal narrowing.

T10-11 Disc bulge at this level, doesn’t appear to be causing any problems

T11-12 mild broad disc bulge and mild facet hypertrophy. (It’s explained in the terminology)

LUMBAR SPINE:

You have a mild exaggeration of the lordotic curve (the natural curve we have in our backs) Mild to moderate age related DDD and spondylosis. And small Schmorl’s nodes at T11-12 (see terminology)

There is mild reactive marrow edema adjacent to the endplates posteriorly at L2-L3.

The bone-marrow edema is a common finding in osteoarthritis and RA; it’s a protective reaction of the body in response to an injury or stress. In simple terms, bone marrow edema means there is fluid within the bone marrow.

T12-L1 Disc protrusion mildly narrowing the foramina on the right side
.
L1-L2 mild broad disc bulge, mild foraminal narrowing
  
L2-L3 mild to moderate broad disc bulge into left foramina. Mild Facet Degenerative Joint Disease, Mild to Moderate narrowing of lateral recess (an area on the side of the spinal canal that nerves travel) near L3 nerve root, probably from the facet DJD

L3-L4 mild to moderate broad disc bulge.  There is a small central disc protrusion with a peripheral annular tear (tear in the outer ring of the disc) Facet DJD is mild bilaterally (both sides).  Foraminal stenosis is mild on the left.  There is mild left lateral recess stenosis near the left L4 nerve root.  

L4-L5 demonstrates a mild to moderate disc bulge.  Facet DJD is mild on the left and mild to moderate right.  Foraminal stenosis is mild on the left and mild to moderate on the right.  There is mild lateral recess stenosis bilaterally near the L5 near roots.  No central canal stenosis.
L5-S1 demonstrates a mild broad disc bulge with a central peripheral annular tear.  Facet DJD is mild bilaterally.  No central canal stenosis or foraminal narrowing.

The pain you have in your chest is probably from some of the problems you have in the T-spine, In particular at T8-9 you have some cord compression form a disc protrusion and at T9-10 the bulge is supposedly just touching it. This can generate a lot of pain and cause neurological problems like leg weakness. You definitely need to discuss this area with the Doctor; the concern is that it could get worse. The other thing is the foraminal stenosis; you might have a nerve that’s being pinched. The report states that it’s not significant or mild, but that doesn’t necessarily reflect reality, MRI reading is very subjective and the Surgeons generally look at the films themselves and come up with their own conclusions.

The pain in your low back is probably being influenced by a variety of factors, including your disc degeneration and facet joint problems. The pain in your legs, foraminal stenosis i.e. pinched nerves. Of concern, nerve roots at L3,L4 and L5, the report states that their not currently being pinched but this needs to be confirmed, and also you want to ask about the chances that the stenosis will eventually cause problems if nothing’s done.

Should what’s wrong with your back cause a lot of pain? Yes and I doubt if it has anything to do with low pain tolerance. Some of it is natural aging, but there are some legitimate concerns here.

As far as your activity, I wouldn’t play football right now if I was you, but aside from that you really need to discuss this with your Doctor.

Let us know how your appointment goes and what he/she recommends.


Take Care
Blank
Avatar_m_tn
Thank you so very much for the courtesy of your time in answering my questions and concerns.  You've put my mind to rest as is appears as though my issues are fairly minor. From reading what others have written, it's clear that many individuals have problems that are far more serious than mine. For that I'm thankful. That being said, obviously I have a few things that need to be addressed by my doctor; the stenosis and the pinched nerves.  

You cetainly helped my self esteem. I'm glad that I'm not totally "whimping" out and have a legitimate reason for feeling the pain that I do.

I'll let you know how my appointment turns out. And again, thanks.
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