Had a Papaya Injection L4-5 in 1984, and a particale laminectomy in 1995. Ster Injection Lumbar 2003 and 2008. Now it’s all getting worse. Spine Surgeon sending me to pain management, says I’m not a canidate for surgery at this time. Not sure what he meant?
MRI OF THE LUMBAR WITHOUT AND WITH CONTRAST 12/22/2008
There is desiccation and narrowing of intervertebral discs from level of L3 through S1.
At the level of L1-2, there is no evidence of focal disc protrusion or significant canal or neural foramina stenosis.
At the level of L2-3, the intervertebral disc is mildly circumferentially bulging with an element of early vertebral osteopthytic ridging circumferentially. Disc changes are very slightly asymmetric to the left and cause fattening and mild indentation of the anterior margin of the thecal sac without canal stenosis. There is bilateral facet hypertrophy which is slightly more prominent on the right. The disc/osteophyte complex does mildly contact the exiting right L2 root within the foremen.
At the level of L3-4, there is moderate bilateral facet hypertrophy. The intervertebral disc is desiccated and circumferentially bulging, slightly asymmetric to the left. There is a tiny fluid-filled annular tear in the central disc margin. The disc material mildly indents the anterior margin of the thecal sac, slightly asymmetric to the left. The combination of disc bulging and facet hypertrophy causes minimal narrowing of the inferior aspect of bilateral neural foramina without direct nerve root compromise.
At the level of L4-5, there is postsurgical change related to previous laminectomies. The intervertebral disc is narrowed and mildly circumferentially bulging with an element of early circumferentially vertebral osteophytic ridging. There is no significant mass effect on the thecel sac or evidence of overall canal stenosis. Disc/osteophyte complex formation extends into both neural foramina causing a mild degree of narrowing, slightly greater on the right with direct contact with the exiting right L4 root at the foramina exit.
At the level L5-S1, the inervertebral disc is mildly bulging without evidence of focal protrusion of significant canal or neural foramina stenosis.
The post contrast images demonstrate subtle enhancing surgical scar in the laminectomy defects at L4, slightly greater on the left without evidence of significant mass effect on the thecal sac or arising nerve roots.
A fatty fllum is present, best seen in the sagittal plane (series 3 image 6) measuring approx. 3.9 cm in length x 0.4 cm in max. width. The conus terminates in normal position, however.
There is no gross abnormality seen in the parespinal soft tissues.
MRI CERVICAL SPINE WITHOUT CONTRAST: 9/26/09
Alignment of the cervical vertebrae is normal. The vertebral bodies are normal in height. No areas of significant marrow signal alteration are identified in the vertebrae.
At the level of C2-C3, there is no disc protrusion or canal or neural foraminal narrowing.
At the level of C3-C4, there is no focal disc protrusion. There is moderate right and mild left neural foraminal narrowing due to uncinate and facet hypertrophy.
At the level of C4-C5, there is bilateral uncinate and facet hypertrophy causing minimal narrowing of the right neural foramen. The left neural foramen is patent. There is mild disc bulging flattening the anterior margin of the thecal sac.
At the level of C5-C6, there is minimal disc bulging flattening the anterior margin of the thecal sac without focal protrusion or cord impingement. There is early uncinate and facet hypertrophy bilaterally causing subtle narrowing of the caliber of the bilateral neural foramina without direct compromise of the exiting roots.
At the level of C6-C7, there is no evidence of focal disc protrusion or canal or neural foraminal stenosis.
At the level of C7-T1, there is no disc protrusion or canal or neural foraminal stenosis.
No areas of signal alteration are seen within the spinal cord. The visualized portions of the posterior fossa and craniocervical junction are grossly normal.
No abnormality is seen within the visualized paraspinal soft tissues.
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