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Need help understanding MRI results for back and neck.

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Last week my father went in for an MRI and he recieved the results from the doctor on Thursday. The doctor did not sit down and explain to him exactly what this stuff meant so my dad is really in the dark with what exactly is wrong with him. Anyway, the two types of MRI's that he had done is:
Lumbar Spine & Cervical Spine
On the Lumbar Spine readings this is what he has:
The conus medullaris lies at the level of the L1-L2 interspace.
There is a disk desiccation, intervertebral disk space narrowing and spurring and osteophyte formation at L5-S1.
There is mild disk bulging at L1-L2. There is no evidence of cord compression, spinal stenosis or neural foraminal stenosis at this time.
there is mild to moderate disk bulging at L2-L3. There is bilateral facet hypertrophy at this level. there is mild to moderate impingement upon the left lateral recess. There is mild inpingement upon the right lateral recess. There is no significant spinal cord stenosis.
there is mild disk bulging at L3-L4. there is bilateral facet hypertophy at this level. There is marked impingement upon the bilateral lateral recesses. There is no significant spinal stenosis.
There is mild to moderate disk bulging at L4-L5. In addition, there is a superimposed right posterolateral disk herniation as seen on parasagittal images #3 #4. There is ligamentum fiavum hypertrophy and bilateral facet hypertrophy. There is borderline spinal stenosis. there is seveere impingment upon the bilateral lateral recesses.
There is moderate to severe diffuse disk bulging at L5-S1. There is bilateral facet hypertrophy at this level. There is severe impingement upon the bilateral lateral recesses. There is no significant spinal stenosis.
Disk Bulging at L1-L2, L2-L3, L3-L4, and L5-S1 most severe at L5-S1 level
Disk Buulge and superimposed right posterolateral disk herniation at L4-L5
Spinal stenosis at L4-L5.

Cervial Spine MRI findings:
There is straightening of the cervial spine suggestive of underlying muscular spasm.
There is midline posterior disk herniation at C2-C3 as seen on parasagittal image #6 and axial imagie #2. there is elevation of the posterior longitudinal ligament and impingement upon the ventral thecal sac. There is no evidence of cord compression or exiting nerve root impingment at this level at this time.
There is a midline posterior disk herniation at C3-C4 as seen on parasagittal image #6 and axial image #6. There is elevation of the posterior longitudinal ligament and impingement upon the ventral thecal sac. There is no evidence of cord compression or exitir g nerve root impingement at this level at this time.
At c4-C5, the tecal sac and neural foramina appear widely patent. There is no evidence of cord compression or exiting nerve root impingement at this level.

there is moderate diffuse disk bulging at C5-C6. there is bilateral face hypertrophy at this level. There is severe bilateral nueral forraminal stenosis, right greater than left. There is no evidence of cord compression.
there is mild to moderate diffuse disk bulging at C6-C7. There is a radial tear involving the posterior c6-c7. There is a raidal tear involving the posterior c6-c7 disk. There is a bilateral facet hypertrophy at this level. There is moderate to severe bilateral neural forminal stensis. there is no evidence of cord compression.
At C7-T1, the tecal sac and neural foamina appear widely patent. there is no evidence of cord compression or exiting nerve root impingement at this level.
Impression:
Straightening of the cervical spine suggestive of underlying muscular spasm.
Midline posterior disk neriations at C-2-C3 and C3-C4
Disk bulging at C5-C6 and C6-C7.
Radial tear involving the C6-C& disk.


I apologize that this is so long but I really wanted to get in detail what exactly is wrong with my dad. It seems everytime he goes tot he doctor and questions thiem about this they kind of just blow him off and don't want to get right down to what the problems are.. I think they are just kind of pushing him away because they don't want to have to deal with him. Thanks for all help. It is much appreciated. He's having trouble turning his neck and can walk but not without difficulty. So anything would be very beneficial! sunny
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replied March 26th, 2011
Especially eHealthy
NickiJB,

I can try to explain what the medical terms are. However, not all anatomical findings on an MRI correlate with a patient's symptoms. Without ever having seen the patient, it is impossible to determine if a finding has any significance. That is why it is so important to insist that the doctor explain the study while in his/her office.

That said, here goes:


"The conus medullaris lies at the level of the L1-L2 interspace." --> This is normal, it is the end of the spinal cord and it stops at the appropriate level.

"There is a disk desiccation, intervertebral disk space narrowing and spurring and osteophyte formation at L5-S1." --> The disc at the interval between the fifth lumbar vertebra (L5) and the top of the sacrum (S1) has lost some of its water content and height, the first stage of disc degeneration. There are some bone spurs off the vertebral bodies.

"There is mild disk bulging at L1-L2. There is no evidence of cord compression, spinal stenosis or neural foraminal stenosis at this time." --> This is essentially normal. There is a mild bulge of the disc, but over half of all people without any back problems, will have disc bulges on MRI. It's an anatomical finding as discs age.

"There is mild to moderate disk bulging at L2-L3. There is bilateral facet hypertrophy at this level. There is mild to moderate impingement upon the left lateral recess. There is mild inpingement upon the right lateral recess. There is no significant spinal cord stenosis." --> The disc bulge here is a little more than the previous level. The facet joints, which are located in the posterior aspect of the vertebra, are enlarged. This is an early sign of joint degeneration. This enlargement causes some narrowing of both of the lateral recesses, which are grooves that the nerve roots run through. Stenosis means constriction or narrowing.

"There is mild disk bulging at L3-L4. There is bilateral facet hypertophy at this level. There is marked impingement upon the bilateral lateral recesses. There is no significant spinal stenosis." --> Again a disc bulge, and enlargement of the facet joints. Here there is quite a bit of narrowing of the recesses.

"There is mild to moderate disk bulging at L4-L5. In addition, there is a superimposed right posterolateral disk herniation as seen on parasagittal images #3 #4. There is ligamentum fiavum hypertrophy and bilateral facet hypertrophy. There is borderline spinal stenosis. there is seveere impingment upon the bilateral lateral recesses." --> There is a tear (or break) in the annulus (the outer fibrous ring of the disc), which is located on the right side, back and outer edge. Some of the disc material has squirted out (herniated). But, it does not say that the material is pressing on a nerve. The ligamentum flavum, also called the yellow ligament, is a pair of stout bands that runs up and down the inside of the spinal column, helping to hold the vertebrae together. It is a little enlarged. The facet joints are enlarged and are impinging (or narrowing) the lateral recesses. The size of the spinal canal is at the lower end of normal (borderline stenosis).

"There is moderate to severe diffuse disk bulging at L5-S1. There is bilateral facet hypertrophy at this level. There is severe impingement upon the bilateral lateral recesses. There is no significant spinal stenosis." --> I don't know why the radiologist put half of this disc's description at the beginning, then finished it up here? Here the disc is bulging quite a bit, but there is no tear. Again, the facet joints have enlarged and are narrowing the recesses.

"Disk Bulging at L1-L2, L2-L3, L3-L4, and L5-S1 most severe at L5-S1 level
Disk Buulge and superimposed right posterolateral disk herniation at L4-L5
Spinal stenosis at L4-L5." --> This is the radiologist's summary. Though there is narrowing of the recesses and a disc herniation, there is no mention as to whether or not the nerves are being pressed on. Here, is where it is important to know the patient's exam and symptoms, to determine if any of these findings could be causing the problems.



Cervial Spine MRI findings:

"There is straightening of the cervial spine suggestive of underlying muscular spasm." --> The normal curve of the C-spine is straightened some. This can be due to spasm or positioning during the exam.

"There is midline posterior disk herniation at C2-C3 as seen on parasagittal image #6 and axial imagie #2. there is elevation of the posterior longitudinal ligament and impingement upon the ventral thecal sac. There is no evidence of cord compression or exiting nerve root impingment at this level at this time." --> The images are just the specific frames of the MRI that shows the herniation the best. The disc herniation here is directly posterior, toward the spinal cord, rather than lateral (toward the sides) where the nerve roots exit. The herniation is causing the posterior longitudinal ligament (another stout band that runs up and down) to lift off the bone some. The ligament is pushing a little on the sheath that contains the spinal cord and spinal fluid. However, even though there is an herniation it is not compressing the roots or cord.

"There is a midline posterior disk herniation at C3-C4 as seen on parasagittal image #6 and axial image #6. There is elevation of the posterior longitudinal ligament and impingement upon the ventral thecal sac. There is no evidence of cord compression or exitir g nerve root impingement at this level at this time." --> See the above description.

"At c4-C5, the tecal sac and neural foramina appear widely patent. There is no evidence of cord compression or exiting nerve root impingement at this level." --> There is no compression of the cord or nerve roots. The spaces are wide open (patent).

"there is moderate diffuse disk bulging at C5-C6. there is bilateral face hypertrophy at this level. There is severe bilateral nueral forraminal stenosis, right greater than left. There is no evidence of cord compression." --> Again, a disc bulge, no herniation. The facet joints are enlarged and both of the holes that the nerves run though (neural foramina) are narrowed, the right side worse than the left. It does not say if the nerves are pressed upon.

"there is mild to moderate diffuse disk bulging at C6-C7. There is a radial tear involving the posterior c6-c7. There is a raidal tear involving the posterior c6-c7 disk. There is a bilateral facet hypertrophy at this level. There is moderate to severe bilateral neural forminal stensis. there is no evidence of cord compression." --> There is a bulge and tear in this disc, directly in the back (posterior). The facet joints are enlarged and narrow the holes quite a bit. Doesn't say the nerves are being compressed.

"At C7-T1, the tecal sac and neural foamina appear widely patent. there is no evidence of cord compression or exiting nerve root impingement at this level." --> This level appears normal.

"Impression:
Straightening of the cervical spine suggestive of underlying muscular spasm.
Midline posterior disk neriations at C-2-C3 and C3-C4
Disk bulging at C5-C6 and C6-C7.
Radial tear involving the C6-C& disk." --> Again, this is the radiologist's summary. There appears to be some spasm (but again, this could be positioning, would need patient correlation to determine this). There are some bulges. There are tears of the disc annulus at C2-3, C3-4, and C6-7, with herniation of the nucleus pulposus (the jelly portion of the disc) at C2-3 and C3-4. There is no evidence of nerve or cord compression.


Again, I can explain the words, but as to what they mean in your father's case is something that you and he need to discuss with his surgeon. Radiologists often close their dictation with "clinical correlation needed", because they do not know if the findings are significant or not.

Unfortunately, we often don't want to bother a busy physician, but it very important to ask questions. When the doctor is with you, you are his/her most important patient. Don't be afraid to ask any and all questions, and continue until you are sure you understand.

Hope that helps some. Good luck.
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replied May 14th, 2013
hope this helps =)
Hello, I'm 21 and have had multiple ruptured, herniated, and slipped discs( all in the lumbar though.) Severe Spinal Stenosis is a RED FLAG that he has very bad spine damage. He is going to have to take it extremely easy. I am disabled for life because I did not stop working or stop going to school when i had the herniated discs until my left leg was paralyzed. Three months after the first back surgery( discectomy L5/S1 for the ruptured disc that exploded into my nerves) I went back to work and school 60 hours a week. After 3 weeks of work/school I herniated 2 more discs and was completely disabled again. I had a spinal fusion at L5/S1 6 months ago and was completely pain free 1 month later. Then it was all downhill from there. The doctor said I would be in worse pain after the fusion, but I was actually in more pain before the fusion. Do not have a fusion unless you are screaming and yelling and the pain is 10/10 for 6 or more months and you physically cannot take it anymore. All this started almost 1 year ago and now I am completely disabled, I am having neurological loss in my left foot, severe back pain, sciatic pain shooting down the left leg. PLEASE PLEASE get multiple opinions from 3 well known spine surgeons before you consider a fusion, a discectomy or laminectomy is a far better choice because they are much less invasive surgeries, but surgery doesnt do very much for back pain in the long run, It's really for nerve pain and neurological loss. I really don't want anyone to have to go through what I am going through. I cant go any higher on the pain meds or my body would shut down and I'm still in severe pain a lot of the time. Try physical therapy, epidurals, pain meds, ice on your back( never heat but a hot shower is ok.) Blood thinners slow down the healing process, but help with pain avoid them if you can. If you have severe nerve pain( which would be in your chest,shoulder, or arm for your disc location) and it constantly gets worse then the disc is probably herniating further( you will not get any relief if this is the case) then I would recommend a microdiscectomy, discectomy, or laminectomy so they can remove part of the disc and decompress the nerve roots. Try all non surgery options first. Hope this post isn't to late! good luck. All of this info is from my personal experience with 2 spine surgeons. The one who did my fusion is ranked the 27th best surgeon is the United States, and no relief from the fusion. Avoid a fusion if you can!
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replied September 25th, 2013
I'm supposed to use a cane or walker due to loss of sensation, I'm a little susceptible to falls..., but I have 3 kids and they enjoy playing with them so I do my best without them... I get around pretty well, but I'm having the same problem with multiple disc protrusions... I already had a spinal fusion and the discs replaced on L3-L5 back in 2005... I started having a lot of pain last year, increased numbness, tingling in my arms and face, anyway I was diagnosed in September if 09 with spinal stenosis in my cervical column... I'm not a rough person so I know something is up... My brother also had to have discs replaced last year, he's had problems since he was a teenager but I attributed his to being 6'4...

Anyway, after talking with a second neurologist yesterday and having repeat MRIs done, I have one good disc in my neck... Every other one except a ruptured one is protruding... I'm not a lazy butt, pretty active... The one disc that has ruptured has a calcium deposit, arthritis, which my body grew to stabilize my neck.. Oh, yeah, forgot, also the area above my previous spinal fusion if messed up a bit... They're sending me back to my old neurosurgeon and the pain dr says no more steroid epidurals til I talk to the neurosurgeon....

My QUESTION... Is this a vitamin deficiency or what...???

When I had my MRIs a year ago, the ruptured disc was bulging...

I'm tired of this, I try to laugh at everything, btw, love the mouse story...

Also want to note, I have lupus and arthritis goes along with lupus but I've read bone degeneration isn't caused by lupus... Also about a year after my fusion, I became a tae kwon do addict, stretching, no hard contact, just stretching, I had to have pancreatic surgery in march of 2012 because of a tumor and hypoglycemia... Anyway, it's just interesting that I stopped TKD and I had that surgery and its gotten so much worst...

I need to stop it... My hands do the tingling thing almost every day... I know this probably sounds crazy but I don't have time for this.... I'm a single mom with three crazy kids and this started when I was 35 and I am 43 now...


If anyone has a clue what could be causing it or how to stop it, TELL ME.
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