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Multiple disc bulges/protrusions in cervical/lumbar spine

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Just got my MRI results back today .. This is the basis of it;
Cervical
c2-c3: central disk protrusion. mild central spinal.
c3-c4: broad-based disc bulge. mild central spinal & left greater than right neural foranimal stenosis.
c4-c5: broad-based disc bulge. mild central spinal
c5-c6: broad-based disc bulge. mild central spinal & left neural foraminal stenosis.
c6-c7: broad-based disc bulge
Degenerative changes most significant at c2-c3 & c3-c4. disk desiccation at c2-c3 & c3-c4
Lumbar;
l2-l3: broad based disc bulge, mild central spinal stenosis. mild bilateral neural fornimal stenosis
l3-l4: broad based disc bulge, mild to moderate central spinal stenosis. mild bilateral neural fornimal stenosis.
l4-l5: broad based disc bulge. mild central spinal stenosis, mild bilateral.
l5-s1: broad based disc bulge. mild central spinal stenosis
mild degenerative changes most significant at l3-l4 & l4-l5.
I'm only 25. There have been no "major" injuries/accidents. I was in a car accident 3 1/2 years ago which resulted in no injuries. I'm unsure of how or why there are so many issues occuring. Does anyone have any experience with this many "disc injuries?" I'm being referred to a pain management and spine specialist next week. I've been in PT for 3 weeks, on a muscle relaxer as well as Tramadol. No relief. numbness/burning/tingling in right arm. pain in neck/head/upper back. muscle spasms in right upper back/shoulder/neck and now right leg. general leg weakness. nausea, dizziness, extreme pressure at back of head/skull base.
The MRI seems intimidating.. The amount of issues & all. I'm worried that even if they get some of the symptoms under control with the injections, that it will cause me more issues down the line?
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replied January 31st, 2012
Especially eHealthy
kadebraylen,

In general, this is not a bad MRI.

Bulges are not injuries to the disc. Think of the cartilage portion of the disc as a car tire. If a car tire is underinflated, it will have a generalized broad based bulge all the way around. Well, the disc is the same way. If the disc has a little less water in it than it is supposed to have, the disc will bulge out a little around the middle. In part of the reading, it says that you have some dessication of a couple a cervical disc. Dessication means that something is getting dry, losing water. But, again, it is only listed in two of the discs.

The bulging that is occurring is causing MILD narrowing (stenosis) of the central spinal canal and neural foramen. The central canal is where the cord is and the neural foramen are the holes through which the nerve roots exit the spinal canal.

Okay, so they are MILDLY narrowed. There is no mention that the cord is being affected, at all, or that any of the nerve roots are being touched, let alone compressed.


Also, at what point does a finding go from "normal" to "mild"? It is very subjective and is up to what the radiologist wants to call it. Which is why the physician who orders the study needs to actually look at the images to see if he/she agrees with the radiologist's reading (and not just taking the report as totally accurate).


Another thing that has to be taken into consideration is that disc bulges may not be abnormal. They can be seen on the MRI of patients who absolutely no back problems of any kind. And not just once in a while, the incidence of asymptomatic disc bulges is around 40% of the population.

So, just the presence of disc bulges, does not mean that that is what is causing the problems the patient is having. The findings on any study have to be correlated with the patient's history, symptoms, and physical exam.


Again, overall, this is not a terrible MRI.

You have some very early mild degenerative changes (dessication) at a couple of cervical discs. And you have some generalized broad disc bulges that mildly narrow the canal or foramen. But, there is NO mention of any tears in the discs (within the annulus fibrosus, which is the outer cartilage disc), NO herniations of the nucleus pulposus (which is the jelly like center of the disc complex), NO nerve roots are being touched (let alone compressed), and the spinal cord is not even mentioned, so it can be considered normal. There is NO mention of spondylosis, which is the degenerative changes in the anterior spine. There is NO hypertrophy of the ligamentum flavum or facet joints, which is usually indicative of degenerative changes in the posterior spine.

So, again, these are very minimal findings. This is not a terrible MRI.


However, the findings do need to be correlated with your history, symptoms, and physical examination. Which is what the spine specialist and the pain management physician should do when you see them. Until that is done, they are just findings on a study without too much meaning. Could these finding be causing your problems? Sure. But, they could just as likely NOT be causing your symptoms.


Good luck. Hope you find a pain management regimen that allows you to manage your pain so that you can lead a productive and enjoyable life.
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replied April 4th, 2013
Back pain, dizziness
Have you had a vitamin D test? I have disk herniations so put symptoms very similar to yours all down to disk problems. Was told dizziness was viral ear infection although it continued for over a year. Had muscle spasms all over the place, aching neck and shoulders. Couldn't carry any weight and even house work was getting too much. Was finally sent to a rheumatologist who did a scan and a vit d test. Was gobsmacked when after waiting 8 weeks for a result that I had practically nil vit in my body (Was 3 and should be at least 35 minimum). After about 4or so months of vit d tablets the dizziness stopped. Also bleeding gums stopped which I hadn't connected as a symptoms. Also painful soles of feel if walking fast on a hard floor . So I'd had probs for over a year and at least 3 docs just said it was muscle spasms and ear infection but it was mostly vit d deficiency.
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replied May 14th, 2013
DDD, herniation, bulges, low Vit D
Hi, at 20 years old (female)I began having lower back and hip pain, MRI said small insignificant
Laberal tear. Years later the pain traveled to my neck. I began getting serious muscle knots and spasms that landed me in the ER for morphine several times.
At 28 yrs old I had a cervical/lumbo sacral MRI that revealed large herniation at c6-7 pressing into my spinal canal, multiple bulges c5-6,l2-3,l3-4,l4-5, degeneration from c2-3-4-5. Now at 29 yrs. old im expected to have a discectomy and artificial disc replacement on c6-7. My labral tear hip surgery will come one day. My vitamin D level was recently tested and was borderline deficient, at level 20, normal 35 or so. There's no telling how long it's been low. Vit D deficiency can cause musculoskeletal problems. I think it should be a first line test for people with back/joint pain.
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