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Understanding MRI results

Understanding MRI results


An MRI report showed:
Examination shows no fracture, subluxation, or bone marrow signal abnormality aside from a small focus of signal hyperintensity in the L3 vertebral body presumably representing an incidental intraosseous hemi-angioma. Conus medullarius is in proper position. There is a mild rightward curvature about the lumbar spine, which could be positional and should be correlated with physical examination to evaluate for scoliosis.
Posterior to the L2 vertebral body, left paracentral aspect, there is a 7mm focal signal abnormality, which follows disc signal. This lies approximately 7mm cephalad to the L2/3 disc space but is suspicious for a small extruded disc fragment. This is only seen on one axial image and is best appreciated on the sagittal sequences. Additional evaluation with thin section multiplanar slices through this level would be recommended.
At L3/4 there is small disc protrusion with osteophyte formation at the level of the left lateral recess and neural foraminal associated mild stenosis at this level. L4/5 shows mild broad-based disc bulge and mild bilateral facet degeneration without focal disc herniation. Mild bilateral neural foraminal stenosis is noted. There is central spine stenosis.
At L5/6 there is shallow broad based disc herniation, centrall measuring 13mm transverse dimension and 2mm AP dimension without significant acquired spinal canal stenosis. There is also mild bilateral facet degeneration at this level. There is mild bilateral neural foraminal stenosis.
Conclusion:
1. Apparent dextroscoliosis, however, should correlate with physical examination as this could also be positional.
2. 7mm focal signal abnormality posterior to the L2 verterbral body. This is suspicious for a small extruded disc fragment from the L2/3 disc; however, a more definitive evaluation with multiplanar thin section imaging through this level would be recommended.
3. Disc osteophyte complex with local recess and neural foraminal stenosis at L3/4.
4. Degenerative disc disease changes and facet degeneration are also noted at L4/5 and L5/S1 with associated neural forminal stenosis. There is also a shallow broad based disc herniation at L5/S1.

I saw a neurosurgeon 3 weeks after pain began. He stated I had a herniation at L2, to try PT for 6 weeks, if no relief, he would recommend injection for pain control and if no effect, surgery. States if pain subsides, to call and cancel follow up appointment. I have had some improvement in pain; ie, not excruciating pain, but have mild-severe pain daily that is unrelieved with NSAIDS. Lortab or laying flat relieves pain. . Pain is worse with sitting and bending forward. I interpret MRI as herniation at L2/3 AND L5/SI. Is anything else remarkable on the MRI? Thanks for any input.
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