I was curious to see if anyone out there could translate this MRI report for me; in layman's terms.
Any input is very much appreciated.
I've only just turned 30 years of age, and have been in no accident, or suffered any prior injury. My orthopedic claims that I have "he spine of a 50 y/o. Along with the strength of a 78 y/o in the lower extremities."
Can someone please help explain what is going on?
Thank you, in advance!
"Sublux or aggressive bony lesion is seen. Mild left convex curvature of lumbar spine.
At L5 there is loss of T2 signal within the intervertebral disc consistent with disc degeneration. Shallow broad-based central and towards the left disc protrusion. Mild endplate spurring associated with this disc bulge/shallow protrusion. The disc extends to the left anterior S1 nerve root but does not displace or compress the nerve root. No thecal sac compression. Minimal encroachment on the left neural foremen.
Impression: Degeneration of the intervertable disc at L5-S1 with a broad-based shallow central the left disc protrusion associated with mild endplate spurring. This disc extends to the anterior margin of the left S1 nerve root but without significant compression or displacement of the nerve root. No thecal sac compression."
Degenerative disc disease is common to all bipedal mammals.
Your case is still in the mild stage, but will deteriorate with time. To give you some perspective, I first showed signs of DDD in my late 20s -- almost 40 years ago. My diagnosis then was DDD "remarkably advanced for his age."
Your MRI indicates a bulge or protrusion of the bottom disc, that pushes backwards to the left, but does not impinge your spine or nerve root -- this is good.
You also have a slight tilt in your lumbar spine because of this bulge. You see, each vertebra of the spine rests on the disc, and is supported by two facet joints on either side of the central spine. When the disc is not level, the spine tilts.
Please study the anatomy of the lumbar spine. You'll find that this final, L5/S1 disc is slightly off-center, as the L5-S1 juncture maintains pelvic tilt. Since this disc takes the weight of the entire spine, it is often the first to show disease.
We do not understand disc disease. It could be genetic, or it could be mechanical -- but we do know that some people live their entire lives w/o disc disease, and others have terrible disc disease that is asymptomatic for pain.
You and I are one of the lucky ones -- it hurts. Your pain could be caused by a number of factors, one if which is called discogenic pain -- meaning the pain is coming from cracks in the outer surface of the disc. If this is the case, your disc may heal within 18 months and pain will be reduced. Also, today there are treatments for to seal these cracks with heat.
But often, surgery is required to stabilize the spine. In your case, this may not be necessary. Also, if you have a surgical consult, see a surgeon who has this philosophy -- "surgery should be avoided until all other conservative methods of treatment have failed."
Seek physical therapy, and the specialty of medicine known as interventional pain management. These are MDs usually trained in anesthesiology, with advanced training in the spine, pain and its medical treatment, and special minimally invasive techniques for reducing that pain. They generally have the credentials, MD, DABPM, which means a diplomate from the American Board of Pain Management.
Seek treatment, ask questions, and study your disease and its treatments.
Thank you so very much for your interpretation. You seem well versed in this subject; which I can image is much to your dismay, to be able to identify. I understand pain is a day-to-day battle, and I hope today is a day of triumph. As we know, mental stressors can greatly agitate our physical pain. To me, being in limbo of receiving diagnosis is the worse.
If I may elaborate further on my condition, maybe you could help point me in the right direction? I've first discovered the intersecting nerve to spine over 10 yrs ago. I did not follow up with treatment at that time, because hey, I was young and pretty afraid of needles. When they ordered a nerve conduction study- I bolted. Years went by, pain just became part of my life, I grew accustomed to it.
Then at age 29 I became pregnant with my first (and only) child. She laid transverse throughout the pregnancy, but we had a problem-free delivery. After that is when the pain in my hips and spine returned, with a vengeance might I add! I again just delt with it. I did not mention it to anyone, because I felt I needed to breastfeed my daughter as long as I could possibly stand it. I was afraid of medical intervention (medication) would prohibit that. I've lasted 16 months! To two weeks ago I just could not bare it any further, and went to the ER. There I had x-rays taken, which showed abnormalities From there I was referred to an orthopedic. Who now has referred me to a neurologist, and physical therapy. My EMG is scheduled next week.
What worries me (and the ortho) so much is the atrophy in my lower extremities. Almost total muscle loss in both legs. Constant urges to urinate, accompanies by awful bladder pains. By the end of the day, my legs feel as if they weigh 100lbs each, and it's a great effort just to drag them along with me... it's pretty bad.
I guess my neurologist is the one to rule out any neuromuscular diseases. After hours of research I've come to find that this is how Parkinson's manifest. This disease is on both sides of my family. I'm more than a bit concerned.
Also, at that. The MRI revealed I have a straight spine; "flat back syndrome" Now from all that I've read, my symptoms could be akin to that condition alone. Hip joint paint, lower back, muscle fatigue in legs...
Could it be possible these are just the side effects of a straight spine? Or does this sound neurological to you? ...numbness and tingling, or complete loss of feeling in the feet is a common occurrence to me.
I can be patient, as I've had for almost 20 years, and meditate the pain away. But it's a nice change to be able to talk about these issues with like-minds/bodies. It seems I upset everyone around me when I bring up probable issues.
I just want to be educated and prepared for whatever outcome may be.
Thank you for your time, and much appreciation to the origins of this forum. Communication is so important with these types of matters. Living in your own head, in pain is not a good way to be.
Healing begins in the mind, right?
Some symptoms may be related to your spine disease, others to the disease known as chronic pain syndrome -- yes, it's also a disease.
I imagine the pregnancy and delivery aggravated your spine condition. Pregnancy causes secretion of hormones that loosen the ligaments, allowing your baby's head to pass through the pelvic opening. These hormones also loosen other ligaments, all over the body, including those in the spine that were helping to keep your spine in alignment.
That lower disc may need to be removed, and those bones fused, but again, seek out the help of the kind of doctor I recommended. You may get some help with your pain, and there may be alternative treatments to help defer surgery.
The neurological risk is in nerve root damage -- this is why the EMG is being performed. Losing the myelin sheath around the nerve root will cause problems for the rest of your life. If this is in jeopardy, you might need to consider decompression surgery sooner than later.
When facing surgery, seek a second or third opinion.
Visit the websites of Dr. William Dillin and Dr. Donald Corenman -- search for them. They contain a wealth of information on your condition and available treatments.
The more you know about your condition and options, the better equipped you become to make the right medical choices.
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