Congenital Narrowing of AP diameter of pedicles

[TheMarMar]

  I had a non contrast MRI and It came out I had congenital narrowing of AP diameter of the pedicles at all levels.   I have had back pain for years. For the longest time I always blamed it on my breast size. It has always been in the same area (lower back) but has got alot worse this year.  The pain does go into both my legs. Although it didn't happen often. This week it will go into my right thigh muscle and almost contract it for several minutes and hurt alot.  That same thigh will also go numb. I noticed when sleeping (it woke me up) the numbness went down to my foot and half my heel was numb. (no pins and needles, numb).  

    I am sick of the pain. I don't know if I should see a neurologist about this or a spine doctor. The ER ordered my MRI because I could not get anything done with my family doctor.  He just felt it was all muscular.  Mind you this was also the guy that feels I am to young for arthritis. (which I KNOW I have).   I am 33.   My father was diagnosed ankylosing spondylitis. I was tested for that 11 years ago and it was negative. Also when I had an xray I was told that I had an extra vertebrae.  I was not told that in the MRI.  This is exactly what the MRI says:

MRI.LUMBAR.SPINAL CANAL

MR examination of the lumber spine was performed on the sagittal and axial plane.

There is preservation of the vertebral body heights and disc space at all levels. No focal disc herniation or spinal stenosis is identified. No paraspinous mass is seen. There are congenital narrowing of the AP diameter of the pedicles at all levels. Normal concus medullaris.

IMPRESSION: Congenital narrowing of the AP diameter of the pedicles at all levels. MR examination of the lumbar spine is otherwise normal. No focal hernation or spinal stenosis indentified. No paraspinous mass is seen.


Should I have a contrast MRI to see if there is anything else going on or will this explain the pain I am in. Can you shed any light on this?

Thank you so much,
              Mary

[TheMarMar]

Thank you so much for response. Leaning forward and sitting down DOES help alot.  I can't seem to walk far without my back being in terrible pain. When in a store I can lean on the shopping cart and it helps alot. If standing near a counter I try to lean forward on it slightly to get help.  Leaning forward to much can also irritate my back.

  Thank you so much for your help and yes, your information IS useful. I plan on making an appointment with a neurologist as soon as I am able.

Thanks again!

Mary

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the cause of your symptoms are. In addition, without viewing your MRI, I can not comment on whether or not the findings explain your back pain (and our role on this website does not include reviewing MRIs). However I will try to provide you with some information.

The spinal cord is encased within the spinal column. The spinal column is made up of several bones called vertebra. Pedicles are part of the vertebral body. Nerves form from the spine and exit the spinal column through a hole created by the pedicle and other parts of the vertebra. Narrowing of this exit area, by a small pedicle, arthritis, a herniated disc, etc., could press on the nerve as it exits, causing a radiculopathy. This would cause a pain that shoots down the leg. However, it would NOT cause pain that shoots down both legs. If your symptoms of numbness and pain consistently go to one leg, you would benefit from evaluation by a neurologist. he/she may choose to do a test called a nerve conduction study and EMG which assess how electricity is conducted along a nerve and how the muscle responds. This will provide information as to whether or not there is a nerve being irritated/damaged.

Sometimes, the significance of a short pedicle simply means that there is a future risk of having pressure on the nerve as it exits the spinal column, as arthritis increases with age.

The role of contrast in imaging of the spine is mainly to identify anything that would light-up (enhance), such as tumors, infection, inflammation. It would be up to the physician who orders the MRI to determine whether or not contrast is necessary. In spinal column (bone) problems, contrast is not always useful.

Your MRI report states that you do not have lumbar canal stenosis (this would be evident on an MRI even without contrast), but in thinking of something that causes both low back pain as well as pain in both legs, spinal canal stenosis comes to mind. The symptoms of lumbar canal stenosis is pain in both calves that occurs with activity and improves with leaning forward or sitting down.

Sometimes, when there is chronic low back pain of unclear cause, physical therapy, prescribed by a physician, may be very helpful in improving the pain.

Thank you for using the forum, I hope you find this information useful, good luck.