MRI

[bookmark22]

My MRI REPORT reveals mild thecal sac indentation by a small posterocentral disc extrusion at L2-L3 level. There is mild posterior subluxation of L2 over L3 vertebral body. small posterocentral disc protrusions are seen at D11-12.D12-L1,Li-2 & L5-S1 level.......what does the report mean in simple english.

[philnoir]

Allow me to suggest at this time that you consult a spine-oriented health site. There you'll find definitions, illustrations of normal and abnormal spine, diseases, treatments, specialities -- all of the fundamental information you need to become knowledgeable about your spine disease.

I've lived with a condition similar to yours for over 35 years, and the only way I've managed to survive with pain levels that have allowed me to live a functional life has been through self education.

In today's internet world, all the information you need to become an expert in your disease is available online.

Here's an adage that I've repeated a lot, because I've found it to be true, not only for me, but for hundreds of people I've counseled over the years with spine disease.

The spine patient who knows the most about their disease, and the available treatment options, their risks, benefits, and probabilities for successful outcome, receives the best pain treatment.

Start with a site like spineuniverse.com. Apart from the basics, like where is the lumbar spine, what is a vertebra, intervertebral disc, nerve root, spinal cord, and other fundamentals, look up degenerative disc disease. Begin to read and learn new terms. For instance, learn the difference between a disc protrusion and a disc herniation. Discover what is meant by extrusion, and the degrees of that particular aspect of spine disease. Learn how these problems classified (mild, moderate, and severe). What is spinal stenosis? What is foraminal stenosis. What is the structure of the thecal sac, and where does it reside.

Directional words like anterior, posterior, dorsal, ventral, distal, sagittal, axial are important in reading MRIs.

There are excellent videos on YouTube, the subject of which is "how to read an MRI of the lumbar spine."

Learn about surgical procedures for the spine, and also interventional pain management techniques.

One bit of advice about surgery -- you'll be referred to a surgeon with your disc extrusion and true subluxation, and with this incomplete MRI report and without seeing your flim, I'll be frank -- you may need some surgery to correct this problem.

But you must know that some surgeons are gung ho -- they really believe in their craft and operate on over half of the people referred to them.

Other surgeons are, I hate to say it, smarter. They operate on perhaps 10% or less of their consults. This is the kind of surgeon you want.

Surgery, especially spine surgery, is a destructive, violent process. It's a one-way street -- once you've had most kinds of back surgery, there's no reversing the process. Back surgery makes permanent changes to your back (meaning the bones) and spine (meaning the soft tissue). Bones are cut, ligaments removed -- back surgery looks like butchery.

There are plenty of videos of orthopaedic surgical procedures of the lumbar spine available on Youtube. When you have some knowledge of spinal anatomy, and what procedures they may be offering you, have a look.

So, here's a rule I learned from a prominent surgeon -- a man who's served as the president of my state's orthopedic surgical society -- what is called a "doctor's doctor," meaning he's the guy that other doctors would go to if they needed back surgery. (even docs have back problems.)

He says this: "surgery should always be deferred until all other more conservative treatment measures have been exhausted." There's a caveat in there -- sometimes surgery is necessary to rescue important nerve tissue, or to stabilize the spine (that supports your entire body.)

Sometimes decompression surgery (removing extruded disc material that is applying a great deal of pressure on the thecal sac, or a nerve root), is necessary.

In cases of severe spondylolisthesis, surgery is necessary. Also in cases of severe spinal stenosis.

So many terms to learn. But its worth it, and the material is all there -- no expensive medical books to buy.

So, start with spineuniverse.com. Learn to talk with your doctors in their own language. (remember that movie where the father of the bride is always telling the young future son-in-law "this word comes from the Greek?" Same in medicine -- lots of Greek roots.).

And your questions are welcome here.

And where's my manners -- Welcome to the pain/spine forums.

Best wishes.

[Tuckamore]

Hello Bookmark,

Welcome to our Pain Management Forum.

It's important to know the antomy of the spine. There are 33 bones that make up the spine. They differ considerably in size and structure according to location. There are seven cervical (neck) vertebrae, 12 thoracic (high back), five lumbar (low back), five sacral (near the base of the spine), and four coccygeal (at the base). The five sacral vertebrae are fused to form the sacrum, and the four coccygeal vertebrae are fused to form the coccyx.

In simple English I'll do my best to explain the result of your MRI as I understand it.

" Mild thecal sac indentation by a small posterocentral disc extrusion" - This is medical terminology for a herniated disc which is impinging (protruding) on the thecal sac (thecal sac is a protective membrane surrounding the spinal cord and nerves.) This is an extremely common finding on an MRI of the spine. Often this comes with age and van be called bulging discs.

" L2-L3 level" - Lumbar Vertebrae 2 and 3 which is simply the location of the herniated disc. Often this comes with age.

" mild posterior subluxation" A medical term used to decribe your spine when one or more of the bones of your spine (vertebrae) move out of position and create pressure on, or irritate spinal nerves. "Posterior" in this framework means towards the back. Simply put your spine has a slight movement in that same L2 n L3 level.

"Small posterocentral disc protrusions" in simply terms this is commonly called "slipped discs".   "D11-12.D12-L1,Li-2 & L5-S1 level" -  these are again the locations in your spine. D 11-12 means Dorsal, though I've normally heard this area called the Thoracic is can also be called Dorsal. L is lumbar,

I don't see anything extreme, slipped discs and bulging discs - however add the subluxation and you have multiple reasons for back pain. I doubt this presents a surgical intervention. How ordered this MRI? They will offer you the best advice.

I'm not an expert is spinal disease. We have a member that may be able to explain and interrupt this better.

Please let us know how you are doing. Keep in touch.

Peace,
~Tuck