i just recieved a copy of an mri and because I must wait a month before I see my neurologist (veterans administration at it's best) I thought i'd look for help in deciphering it here:
mri of the lumbar spine with and without gadolinium
technique: 4 mm. In thickness sagittal and axial images are obtained with t1 weighting before and after the intravenous administration of gadolinium and with t2 weighting.
Findings: I do not identify an abnormal signal in the inferior portion of the spinal cord or the conus medullaris.
There is a minimal levoscoliosis and there is straightening in the normal lordotic curve of the lumbar spine. I do not see evidence for marrow edema or for a marrow replacing process.
There is decreased signal in the lumbar intervertebral discs at the l3-l4, l4-l5, and l5-s1 levels on the t2 weighted images. This change is due to disc desiccation secondary to degenerative disc disease. The signal in the other lumbar intervertebral discs is bright and within normal limits.
There is no bulging, protrusion, or extrusion of disc content at l1-l2, l2-l3, or l3-l4 levels. At the l3-l4 level there are osteoarthritic changes in the apophyseal joints with bilateral lateral recess narrowing.
At the l4-l5 level there is a disc bulge to the right of midline with extra dural impression upon the right sided epidural fat plane and with mild right sided foraminal narrowing. There are osteoarthritic changes in the apophyseal joints at this level with bony overgrowth and resultant bilateral lateral recess narrowing.
At the l5-s1 level there is a disc bulge with extradural impression upon the thecal sac anteriorly and to the right of midline. There are osteoarthritic changes in the apopyseal joints. I do not see foraminal narrowing.
I guess i'll list the parts of the report I do or don't understand:
1. I understand the meaning of the curvature in the spine but not what effect the curvature may have.
2. I understand the meaning of the decreased signal/disc desiccation. I understand what degenerative disc disease is.
3. I do not understand what is meant when they say the "disc desiccation is secondary" to the disease.
4. I understand the vertebrae levels and the labeling of their joints. I understand what "osteoarthritic changes in the apophyseal joints" means. I understand what is meant by "bilateral lateral recess narrowing."
5. I understand disc bulge - but not "extra dural impression upon the right sided epidural fat plane" or "foraminal narrowing."
6. I do not understand "extradural impression upon the thecal sac."
any help in figuring the rest of this out would be greatly appreciated.
you are heading down the road of surgery. The problem at l4/5 is going to lead to siatic pain if you are not already experienceing problems there. The dura is the sheath that is covering the spinal cord and so it appears to be necessary for you to at a minimum, have a micro-laminectomy. I am pretty sure you are going to have to have a full lami along with fusion at that level, and you are also going to be having work done at l5/s1.
You definatly have a lot of problems and they need to get fixed. If you are ready to feel better, go in with a positive attitude and try to be flexible.
You will never be in more pain then when post-surgery but after a bit of time, you will reap the rewards of surgery.