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Help with MRI results

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cantthinkofone

New User, Becoming EHEALTHy
Joined: 10 Jun 2008
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Help with MRI results
Posted: 06-10-08 15:35pm

I will try to make this short as possible. I have had back pain for more then 20 years, I am a 37 yo female living in constant pain. I had fusion surgery at l4-l5 5 years ago and a laminectomy at l5-s1 3 years ago. I have had nerve pain in both legs right worse then left, different areas of numbness and tingling, burning feet and constant low back pain like a gnawing or burning also pain in right hip and knee which gets worse when back pain does. I am currently taking oxycodone, antidepressants, and a few other meds which really dont help much other then take the edge off for an hour or so after I take the pain med, have been for nerve block injections prior to and after surgery, therapy numerous times also before and after. I saw my primary care doc in March and she was supposed to set me up for mri and evaluation by new neurosurgeon. 2 months later in May this still wasnt scheduled. I called for the 3rd time and finally got mri appt. The results came back as follows.

Magnetic susceptibility artifact is seen within the L4-5 disc space related to prior surgery with metallic cage interbody fusion.
There is desiccation of the L3-4 disc with mild to moderate disc space narrowing. There is mild scoliosis convex to the left.

At L1-2 L2-3 Normal
At L3-4 There has been interval development of a right paracentral and lateral disc protrusion mildly indenting the thecal sac. There is no evidence of central canal stenosis. Mild neural foraminal narrowing is present with mild facet joint degenerative changes.
At L4-5 There is laminectomy defect. There is no evidence of disc herniation or central canal stenosis. There is moderate neural foraminal narrowing, left greater then right. Mild epidural enhancement is present.
At L5-S1 There is no evidence of disc herniation or central canal stenosis. A laminectomy defect is present. Facet joint degenerative changes are seen. There is mild epidural enhancemt. There is mild to modertae right and mild left neural foraminal narrowing.
Conclusion:
1. again seen are postsurgical changes at L4-5 and L5-S1 with epidural scarring.
2. Interval development of a right paracentral and lateral disc protrusion at L3-4
Nothing is mentioned in the conclusion about the forminal narrowing seen at each lvl. Is that something that is normal ?
I got a copy of the Mri sent to me and I was told I would recieve it after the Dr was notified. But I had my results days before I heard from primary cares office. When they called, the nurse said everything appeared normal then asked if I had any pain numbness or tingling, I told her I did and that was why the Dr ordered the new Mri in the first place and that they were supposed to schedule an appointment with a neuro who specialized in just backs. I was told they would do that and call me back. They did and my new appt isnt for 3 months. I was wondering what other people think about my situation. To me its not normal to have pain all the time and those results dont look all that normal either, but I am not a Dr just someone who is suffering day in day out. If anyone can give me an opinion of what they think of the Mri results or if they have been thru the about the same thing, I would appreciate it. I know I am not alone although I do feel that way often. Sorry this was so long and thanks for your time. Sad & Confused
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CarolDiane

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Joined: 23 Sep 2007
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Posted: 06-10-08 17:26pm

MRI's are very hard to read. There are a few web sites you can go to if you google in vertabre injuries. Reason being, you have no clue as to what you are looking for or at. I myself get very angry when a doctor does not go over the film with a patient while they are there at the office. Or call them in to go over them. If I were you, I would demand an appointment to go over it with you neuro or doc.
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Zak_han

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Physical examination is more important than MRI for diagnosis .
Posted: 06-14-08 08:07am

Generally speaking, MRI of back will not properly help to identify the cause of the pain.as there are have too many reason whose have same symptoms.another reason is we get older we all have changes in the bones of the back which are due to normal ageing (spondylosis); these changes will be visible on anMRI but, as suggested above, may not be causing the pain.Occasionally a MRI scan may help.

According to your symptoms,my opinion is that you slao suffer from soft tissue injury around L3-L5,which can lead to many symptoms as you said.

Basically,deep and intensive acupuncture can help.
Good luck!
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rollar64

Experienced User , Rather EHEALTHy
Joined: 21 Nov 2006
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Location: melbourne
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Posted: 06-16-08 04:04am

Hi cantthinkofone sorry to hear of your health problems, doctors often say things are normal when they are not, you have some artharitis in your facet joints at L3-L4 these are small joints at the back of the vertabra. Also at this level the disk is touching the thecal sac whith is a membrane that surrounds the spinal cord, Scoliosis is an abnormal sideways curveture of the spine.

neural foraminal narrowing means the grooves between the vertabra that the nerves course out of have narrowed, but it does not say that any of the nerves are being compressed.


Epidural enhancement means that there is inflammation in the spinal canal.




The fact that they did not include the foraminal narrowing in the conclusion probably does not mean anything untoward is going on, its there in the findings so it cannot be denied.

Good luck i hope your neuro can help you
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