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.
I've been battling severe issues in my neck and shoulder for 4-5 years now, I've also had a lumbar fusion in 2003, Since February of 2015 (after a medial branch block diagnostic test) the numbess in my left arm has gone from sometimes to constant, and now it ocassionally pulls up in a state of paralysis (this lasts anywhere from 15 minutes to an hour). My neck "locks" into positions now while awake or sleeping, worse when trying to sleep, I never get more than 2 hours of sleep at a time, --right now I'm on day 4 of 3 hours of sleep total --.
I've recently had a series of MRIs done of my ENTIRE spine - as I've been battling disability for 4 years, and I keep getting denied (I'm only 39 and well my lawyer SUCKED and didn't included any of the key reports on my last appeal but that's not why I'm here). I have until June 20th to submit my appeal, and I cannot get in to see a neurosurgeon or orthopadic spine doctor or shoulder doctor before my appeal paperwork must be turned in, So I need to at least be able to understand the changes in my MRIs enough to write up my appeal to send to social security. I'll include the original MRI report information as well.
Cervical Spine MRI's
11/2013 TOA MRI
November 2013 Cervical Spine - w/out Contrast (I'm deathly allergic to contrast)
**NOTE**This MRI machine is the best in Middle Tennessee and can only be used by certain doctors, my first MRI was completed at this location, subsequent MRIs have been done at regular imaging centers that do not have as new of equipment. ***
General Findings: Mild reversal of the normal cervical lordosis may be positional or degenerative. Cervical vertebral alignment is otherwise normal. No signal abnormality to suggest fracture or destructive osseous lession.
Craniocervical Junction: Visualized portions of the posterior fossa are unremarkable. Mild degenerative changes at the atlantoaxial articulation anteriorly.
C2-3: No significant abnormality identified on the sagittal images.
C3-4: No significant abnormality.
C4-5: Minimal disc bulge without disc protrution. No canal or foraminal stenosis.
C5-6: A broad-based central disc protrusion indents the thecal sac and abuts the ventral margin of the cord. No canal stenosis or cord deformity. Neural foramina are patent bilaterally.
C6-7: A mild disc bulge indents the thecal sac and effaces the ventral CSF. No canal or foraminal stenosis.
C7-T1: No significant abnormality.
Cord: No cervical or intraspinal lesions.
1. 1. Broad-based central disc protrusion at C5-6. This indents the thecal sac and abuts the ventral margin of the cord. 2.
2. Mild disc bulge at C6-7. No canal stenosis or cord deformity.
Cervical Spine MRI March 2015
Findings: The cervical spine is well aligned. No significant listhesis. Vertebral body heights are maintained. No suspicious marrow lesion. There is normal signal throughout substance of the cervical spinal cord. Visualized portions of the posterior fossa are unremarkable.
C2-3: No significant abnormality.
C3-4: Mild LEFT facet arthropathy. No significant stenosis.
C4-5: Mild facet arthropathy. No significant disc bulge, protrusion, or stenosis.
C5-6: Circumferential annular disc bulge approaches the ventral aspect of the cervical spinal cord producing mild central canal stenosis. Uncovertebral and facet arthropathy contribute to mild bilateral foraminal stenosis.
C6-7: Mild broad based annular disc bulge combines with mild uncovertebral arthropathy and facet arthropathy to produce mild central canal stenosis and mild bilateral foraminal stenosis LEFT greater than RIGHT.
C7-T1: No significant abnormality.
1. 1. Mild multi-level degenerative disc disease, uncovertebral arthropathy, and facet arthropathy most pronounced at C5-6 and C6-7.
2. 2. No MR Evidence of intrinsic cervical spinal cord abnormality.
3. Note: was NOT compared to the findings of the NOV. 2013 imaging done at TOA.
C2-3: The spinal canal and neural foramen are widely patent at this level with no extradural, intradural, or intramedullary masses.
C3-4: The spinal canal and neural foramen are widely patent at this level with no extradural, intradural, or intramedullary masses.
C4-5: The spinal canal and neural foramen are widely patent at this level with no extradural, intradural, or intramedullary masses.
C5-6: There is a broad-based posterior annular protrusion of the C5-C6 disc. The protruding portion the disc contains a small focus of increased signal on fluid sensitive sequences. The protruding disc is causing attenuation of the CSF space anteriorly. There is no cord remodeling. There is mild narrowing of the neural foramen at C5-6. No intradural, or intramedullary masses are present. The findings at C5-6 have progressed slightly since prior imaging.
C6-7: There is a posterior annular buging of the C6-7 disc causinngn partial attenuation of the CSF space anteriorly. There is no cord remodeling. The neural foramen are widely patent on the RIGHT and LEFT at this level. Noextradural, intradural, intramedullary masses present.
C7-T1: The spinal canal and neural foramen are widely patent at this level with no extradural, intradural, or intramedullary masses.
1. 1. The paraspinal soft tissues appear normal.
2. The cervical vertebral bodies demonstrate normal height and configuration.
3. The cervical cord demonstrates normal signal on all sequences.
4. Broad-based posterior annual protrusion of the C5-6 disc with signal changes suggesting an annular tear. The protruding disc is causing attenuation of the CSF space anteriorly with no cord remodeling. There is mild narrowing of the neural foramen at this level. The extradural findings have progressed slightly at the C5-6 level since prior imaging of 3/10/2015.
5. Posterior annular bulging of the C6-7 disc causing no significant spinal stenosis of neural foraminal narrowing.
MRI THORACIC SPINE W/OUT Contrast
Date: May 2016 - No prior imaging
Findings: There is minimal/borderline decreased bony AP canal diameter secondary short pedicles throughout the midthoracic region. No significant disc protrusion/disc bulges are noted. Focal fat versus hemangioma LEFT aspect of T4. There is minimal narrowing the LEFT neural foramina at approximately T8-9 secondary to facet hypertrophy. Neural foramina otherwise essentially preserved. Vertebral body height, alignment, and marrow signals are otherwise preserved.
1. 1. Minimal bony canal narrowing throughout the midthoracic region secondary to short pedicles.
2. No significant disc protrusion/disc disease identified.
3. Mild LEFT foraminal narrowing at approximately T8-9 secondary to facet hypertrophy.
Follow up as indicated.
MRI LUMBAR SPINE W/OUT Contrast
date: May 2016 - no prior imaging since 2003 (and I don't have access to those films)
Findings: Postsurgical changes with hardware artifact bilateral pedicle screws and presumed rods L5-S1. Artifact also is present at the L5-S1 disc interspace. Evaluation postsurgica levels limited without contrast on this exam. Vertebral body height alignment appear preseved. Conus terminates at L1. Nonsurgical disc levels appear preserved. Small area of focal fat versus hemangioma at T12. Individual disc level as detailed below:
T12-L1: Minimal bilateral facet hypertrophy and trace LEFT facet effusion. No significant thecal sac or foraminal stenosis.
L2-3: Minimal disc bulge without significant thecal sac or foraminal stenosis.
L3-4: Mild to moderate bilateral facet and ligamentum flavum hypertrophy. Mild disc bulge. AP thecal sac diameter preserved in the midline. Mild LEFT greater than RIGHT foraminal narrowing.
L5-S1: Posterior decompression suggested. AP thecal sac diameter widely patent. No obvious foraminal narrowing.
1. Post surgical changes L5-S1 as above.
2. Mild degenerative change/disc disease as detailed at each individual disc levels above.
Follow up as indicated.
Technique: Magnetic Resonance imaging of the right shoulder was performed using the standard pulse sequences. CPT 73221
History: Separation of AC joint, abnormal should x-ray M25.511 Pain in right shoulder M62.838 Other muscle spasm.
There is fairly extensive motion artifact, reducing overall exam sensitivity, despite multiple imaging attempts. No os acromiale identified. Subscapularis tendon appears to remain intact. Biceps tendon long head appears positioned with the bicipital groove and appears to remain attached to the superior labrum. Integrity of the superior labrum cannot be confirmed. Anterior and posterior labral regions appear intact. Spinoglenoid notch appears unremarkable. There is superior positioning of the lateral clavicle relative to the acromion. However, no significant edema is seen in the region of the joint space. Deltoid insertion appears normal. Scapular notch appears unremarkable. There is moderate distal supraspinatus tendinopathy/partial tearing with no full thickness tear or tendon retraction identified. Infraspinatus tendon appears to remain intact. Teres minor tendon appears intact. Focal cystic appearing region is seen in the superior lateral humeral head. Remainder of marrow signer appears unremarkable.
1. Fairly extensive tendinopathy/partial tearing of the distal supraspinatus tendon with no full thickness rotator cuff tear or tendon retraction identified.
2. Small cystic focus in the superior lateral humeral head. Appearance felt to favor posttraumatic/degenerative cystic change. However, possibility of Hills-Sachs deformity from prior anterior instability cannot be excluded.
3. Evidence for mild acromioclavicular separation with no edema is the region of the joint, suggesting this is probably chronic.
4. Remainder of moderately limited examination appears unremarkable.