MRI Results

Hi. Could someone help me with the following MRI results. My appt with the orthopedic specialist is weeks away and I got my MRI report back and I am very anxious to know what it means. Any and all help would be appreciated! I need to ease my nerves. I had a fusion in my lower back 11 years ago and I have suffered from back pain of some sorts since then (my entire adult life) and at times don't even realize how much pain I am in. I guess after 11 years, the pain becomes part of your life. I have noticed increased pain in my lower back and upper right-hand side of my back over the past year. I have lost 85 pounds over the coarse of the past 2 yrs and now am noticing a "hump" on my upper right-hand side in the bending position. Once again, thank you for any help.

Female, 36 years of age
Exam: MRI Lumbar without contrast (Unpaired)
CPT Code(s): 72148 – MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL
EXAMINATION: MRI of the lumbar spine without contrast, 10/22/08
COMPARISON: None.
HISTORY: Low back pain radiating into the left leg, chronic x11 years; Surgery 11 years ago.

TECHNIQUE: Sagittal and axial sequences were obtained.

FINDINGS:
There is dextrorotoscoliosis at the lumbar spine, perhaps greatest at the L3-4 region. AP alignment shows mild anterior subluxation of L5 on S1. Modic I-II changes are seen at L3-4; elsewhere, marrow appears within normal limits. Discs are desiccated below L3. Conus medullaris is visualized at about T12-L1.

L1-2: Mild facet overgrowth. Otherwise, negative.

L2-3: Greater amount of facet overgrowth. No foraminal stenosis or thecal sac distortion.

L3-4: Left hemilaminectomy at L3. There is marked right lateral subluxation of L3 on L4. The right facet is subluxed and there is ligamentum flavum thickening. The intervertebral disc bulge at both right posterolateral and left posterolateral aspects, with severe left foraminal stenosis and moderate to severe right foraminal stenosis. AP canal width is about 8 mm.

L4-5: Laminectomies are seen at L5 extending into S1. There are findings of posterior fusion bilaterally. Mild central protrusion of disc is seen. There is mild anterior contact of the thecal sac, left of midline. Mild to moderate foraminal stenosis is seen on the left, moderate to mark\ed on the right. Facets appear within normal limits. There is some transverse narrowing of the thecal sac secondary to ligamentum flavum hypertrophy, however, the AP measurement of the canal is 15 mm.

L5-S1: Thecal sac is patulous. There is posterior extension consistent with laminectomies. Moderate to marked narrowing is seen of the neural foramina.

Paraspinous muscle atrophy is seen, associated with laminectomy changes.

IMPRESSION:

1. Acquired spinal stenosis, L3-4, with AP canal with central canal of 8 mm. Moderate to severe bilateral foraminal stenosis.

2. Status post laminectomies with posterior fusion, L5 extending inferiorly and left hemilaminectomy at L3

3. Grade I spondylolisthesis of L5 on S1. Moderate to marked bilateral foraminal narrowing.

[rambler150]

1) this shows the reason for your pain you are having...the moderate to severe stenosis means ...narrowing and the bilateral means shows on both sides...when it has stenosis it is putting pressure to cause pain..yours is moderate to severe...this is in the lumbar 3-4 disk area ...just down below where your first surgery was
2) shows you have had surgery at the lumbar 5 area before

3) you have some curvature of the spine that is moderate and the doctor will tell you more as to handle the areas affected by this

I hope this helps a little bit, good luck

[melindahawk]

Do you think any of my problems would require surgery? The surgery I had in 1997 was rough and painful and took me along time to overcome, so the thought of surgery scares me to death. BUT, on the other hand, I just want to fix my problems and get rid of the pain. The pain keeps increasing as I age, etc. Thank you for your input, I truly appreciate it!