My MRI Results
Do you think u could help me understand my MRI results so i can show my husband? A lot of people think if u complain of back pain it is all in ur head or ur pretending. I would like to be able to help at least my family understand the results. I have live with this for bad pain for 5 yrs. but my back has been bad for 25 yrs. I am looking for a program for pain management but I would like to understand what is wrong first. You think you can help me?
FIVE LUMBAR-TYPE NON-RIB-BEARING VERTEBRAL BODIES DEMONSTRATE ANATOMIC ALIGNMENT WITHOUT EVIDENCE OF ACUTE FRACTURE OR LISTHESIS. VERTEBRAL BODY HEIGHT IS MAINTAINED. THE CONUS TERMINATES AT THE L1-L2 LEVEL AND DEMONSTRATE NORMAL SIGNAL.
THE CENTRAL CANAL AND NEURAL FORAMINA ARE WIDELY PATENT FROM T12 TO L3.
L3-L4: MILD CONCENTRIC DISC BULGE AND MODERATE FACET ARTHROPATHY BUT WITHOUT SIGNIFICANT STENOSIS.
L4-L5: BROADLY BULGING DISC WITH MARKED FACET ARTHROPATHY CREATES MODERATE CENTRAL STENOSIS WITH POSSIBLE INVOLVEMENT OF TRAVERSING L5 NERVE ROOTS. FORAMEN ARE FAIRLY WELL MAINTAINED.
L5-S1: THERE IS DISC DEHYDRATION, SEVERE DISC SPACE NARROWING, AND CIRCUMFERENTIAL BROAD-BASED DISC BULGE CREATING MODERATE BILATERAL FORAMINAL STENOSIS ALTHOUGH THE EXITING NERVE ROOTS DO NOT APPEAR INVOLVED. CENTRAL CANAL WIDELY MAINTAINED.
THE VISUALIZED SACRAL NERVE ROOTS ARE UNREMARKABLE.
"FIVE LUMBAR-TYPE NON-RIB-BEARING VERTEBRAL BODIES DEMONSTRATE ANATOMIC ALIGNMENT WITHOUT EVIDENCE OF ACUTE FRACTURE OR LISTHESIS. VERTEBRAL BODY HEIGHT IS MAINTAINED. THE CONUS TERMINATES AT THE L1-L2 LEVEL AND DEMONSTRATE NORMAL SIGNAL." >>> This is all normal. You have 5 lumbar vertabrae, as it should be. There are no acute fractures or movement of one vertebral body over another (listhesis). The conus is the end of the solid spinal cord. It should end at about the level of L1. Normal signal means the MRI do not pick up any thing like marrow edema, hemangiomas, or any thing else abnormal.
The vertebrae are named by which area they are in, abbreviated to the letter and number of the vertebra. So the first lumbar vertebra would be noted as L1. S1 would be the first sacral vertebra. And so on.
"THE CENTRAL CANAL AND NEURAL FORAMINA ARE WIDELY PATENT FROM T12 TO L3." >>> The central canal is the region where the spinal cord lives. The neural foramina are the holes through which the nerve roots exit the spinal column. Widely patent means the holes are wide open, without narrowing or compression of any nerve roots.
"L3-L4: MILD CONCENTRIC DISC BULGE AND MODERATE FACET ARTHROPATHY BUT WITHOUT SIGNIFICANT STENOSIS." >>> When the disc complex starts to degenerate, one of the first signs is to have bulging of the disc all the way around (concentric). It is sort of like an underinflated tire bulging out. The facet joints are located in the posterior elements of the vertebrae. These joints have moderate degenerative changes which is manifested by some overgrowth of the bone surfaces making up the joints (arthropathy). But, this hypertrophy (overgrowth) does not cause any narrowing of significance.
"L4-L5: BROADLY BULGING DISC WITH MARKED FACET ARTHROPATHY CREATES MODERATE CENTRAL STENOSIS WITH POSSIBLE INVOLVEMENT OF TRAVERSING L5 NERVE ROOTS. FORAMEN ARE FAIRLY WELL MAINTAINED." >>> Again, this disc has a bulge basically going across the whole area of the spinal canal. The bulge does not press on anything. The facet joints again have arthropathy or degeneration of the joint. The hypertrophy here produces some narrowing of the central portion of the spinal canal. The radiologist thinks the L5 nerve root may have some pressure on it within the spinal canal, but can't be sure. The holes are open, without any significant narrowing or pressure on the nerve roots going through the foramina (holes).
"L5-S1: THERE IS DISC DEHYDRATION, SEVERE DISC SPACE NARROWING, AND CIRCUMFERENTIAL BROAD-BASED DISC BULGE CREATING MODERATE BILATERAL FORAMINAL STENOSIS ALTHOUGH THE EXITING NERVE ROOTS DO NOT APPEAR INVOLVED. CENTRAL CANAL WIDELY MAINTAINED." >>> The disc shows significant DDD (degenerative disc disease). The disc has lost height because it has lost its water content (dehydration). Dehydration is the first sign of DDD. And again, the disc is bulging out all the way around. Here the bulge is narrowing the foramina on both sides. But, it does not appear that the nerve roots are being compressed at all. The spinal canal does not have any stenosis or narrowing.
"THE VISUALIZED SACRAL NERVE ROOTS ARE UNREMARKABLE." >>> The nerve roots from the sacral region are normal appearing.
So, you have some DDD and facet joint arthropathy, especially at the L5-S1 level.
There is NO evidence of any tears of the annulus fibrosis, which is the cartilage ring part of the disc complex, at any level. Neither are there any disc herniations of the nucleus pulposus, which is the jelly like center of the disc complex.
The L5 nerve roots might have some pressure on them within the spinal canal, but that is not an absolute. The L5-S1 neural foramina are narrowed, but the exiting nerve roots are okay.
As to whether or not any of these findings is significant or not is something that you need to discuss with your spine surgeon. All studies have to be correlated with the patient's history and physical examination, for them to have any meaning. Until then, these are just findings on a study, which may or may not be causing any problems.
If the examination correlates with a finding on a study, then the surgeon can say with fairly decent certainty, that the finding is actually causing the problem. But, if there is no correlation, then it become a bit more difficult to determine exactly what is causing the symptoms.
Again, you must discuss the results of the study with your physician, since he/she knows your history and has done an examination of your spine.