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Low Back Pain w/ numbness in Knee

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I have had an MRI of the L/S Spine and I have the report But I am confused. Could u interpretate it for me please. mri exam of the lumbar spine includes sagittal and axial T1 and T2 weighted images. Sagittal IR images were also performed. The lumbar vertebral body heights are preserved. Overall bone marrow signal is normal. The conus terminates at L1. Note is made of an L1 vertebral hemangioma. A smaller L3 vertebral hemangioma is also noted. There is mild Multilevel degenerative disc disease with assoc. disc desiccation. at L4-L5 min. disdc bulging which indents the ventral thecal sac. There is mild to moderate bilateral spondylotic neural foraminal narrowing, left greater than right. there is no signif. central canal stenosis. There are no focal disc herniations. The visualized paravertebral soft tissues are unremarkable. Note is made of a 1.2cm left renal cyst. IMPRESSION: Mild multilevel degenerative disc disease with disc bulging noted L4-L5. No significant central canal stenosis.
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replied September 10th, 2011
Especially eHealthy
Mztamcarr,

Sure, I'll give it a go:

"mri exam of the lumbar spine includes sagittal and axial T1 and T2 weighted images. Sagittal IR images were also performed." >>> This is just saying which way the pictures were taken and what techniques were used.


"The lumbar vertebral body heights are preserved. Overall bone marrow signal is normal. The conus terminates at L1." >>> This is all normal, stating the vertebrae are of normal height, there has been no compession. The bone marrow inside the vertebral bodies looks normal. The conus is the end of the solid spinal cord, it normally ends at the level of the first lumber vertebra (L1).

"Note is made of an L1 vertebral hemangioma. A smaller L3 vertebral hemangioma is also noted." >>> An hemangioma is a tangle of blood vessels. They are very common in the spine. They are benign. The marrow cavity of the vertebral bodies normally have a lot of blood vessels in them, and an hemangioma is an area of more than normal number of blood vessels, all sort of tangled together. They are a incidental finding (i.e. it's there, so the radiologist mentions it, but it doesn't mean much).

"There is mild Multilevel degenerative disc disease with assoc. disc desiccation." >>> At several levels there is very early degenerative changes in the disc, manifested by loss of water content (desiccation). This is a very common finding, becoming more common as the patient ages.

"at L4-L5 min. disdc bulging which indents the ventral thecal sac." >>> At the level of the L4-5 disc, the disc bulges outward some. The bulging portion, touches the thecal sac, which is the sheath that surrounds the spinal cord and nerve roots, and contains the CSF. The the L4-5 level, there is no spinal cord to push on, in this region, there is only nerve roots floating in the cerebrospinal fluid. That is why spinal taps are done in this region.

"There is mild to moderate bilateral spondylotic neural foraminal narrowing, left greater than right. there is no signif. central canal stenosis." >>> The neural foramen are the holes through which the nerve roots exit the spinal column. Spondylosis is a general term meaning degenerative changes in the vertebral body portion of the spine (it does not affect the posterior elements, such as the facet joints). So, there is some narrowing of those holes, from the usual aging changes seen within the spine. It does NOT mention any compression of nerve roots. Likewise, the spinal canal, where the cord is, is NOT narrowed (stenosis means narrowing).

"There are no focal disc herniations." >>> The disc complexes (except for the above mentioned early loss of water) are all okay. There are no tears in any of the disc, nor any herniations.

"The visualized paravertebral soft tissues are unremarkable. Note is made of a 1.2cm left renal cyst." >>> The rest of the soft tissue structures around the spine are normal. Of note, the radiologist saw a cyst on the left kidney. Most of these are benign, but the surgeon may have you seen by a nephrologist just to be sure.

"IMPRESSION: Mild multilevel degenerative disc disease with disc bulging noted L4-L5. No significant central canal stenosis." >>> This is just condensing down what was said above. You have a bulging disc with some early disc degeneration.



As to what this all means, if anything, has to be determined in correlation with your history and physical exam. Study results do not mean much taken in isolation.

You need to discuss the results with your surgeon, who knows your history and exam.

Good luck.
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