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help me to understand back Pain MRI result

Hi, i have a back-pain problem and i had taken MRI. this is impression they gave but i am unable to understand. Please help me to understand the severity of it.
1) Lumbar spondylosis
2) Disc desiccation at L2-L3, L4-L5, L5-S1 levels
3) Mild posterier disc bulge intending thecal sac at L2-L3 level.
4) Diffuse posterior disc bulge causing thecal sac indentation at L4-L5 and L5-S1 levels with bilateral neural foraminae narrawing at L4-L5 level
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replied February 16th, 2013
Especially eHealthy
senthilkumar,

I can help you with the terminology:

1) Lumbar spondylosis

>> The lumbar region of the spine is in the low back. It consists of five large vertebrae.

Spondylosis is a general term for degenerative changes within the spine. Unfortunately, with only the radiologist’s final interpertation being given, there is no way to know what exactly the degenerative changes consist of. These can include such things as osteophytes (bone spurs), narrowing of the disc space (reduced disc height), hypertrophy of the facet joints in the posterior aspect of the vertebrae, and hypertrophy of the ligaments about the spinal column.



2) Disc desiccation at L2-L3, L4-L5, L5-S1 levels

>> At these three levels, the discs have lot some of their water content. When the discs start to degenerate, the first thing that happens is that they dehydrate. This is desiccation. When the discs lose water content they can no longer withstand the compressive stress that they are continueally subjected to. Once they begin to desiccated, they are considered to have DDD (degenerative disc disease).

On an MRI, when structures have a lot of water in them, they appear white or light gray on certain images. When the discs lose water, they start to become darker on the MRI. Thus, “black disc disease” is when the discs have lost so much water content that they appear completely black on the MRI images.

Some of the other findings often seen with DDD include decreased disc height, narrowing of the disc space, bulging of the disc, and tears in the annulus fibrosus (the outer cartilage ring of the disc complex).

Again, without the findings of the study, it is not possible to know how extensive the DDD currently is. The radiologist does not even state if the DDD is mild, moderate, or severe. It is just stated that it is present.




3) Mild posterier disc bulge intending thecal sac at L2-L3 level.

>> At this level (L2-3) the disc is bulging slightly to the rear, into the spinal canal. It states that the bulge is “mild”.

The thecal sac is a tough sheath which covers the brain and spinal cord. It holds in the CSF (cerebrospinal fluid), which continually baths the neural structures.

So, this disc touches and indents the thecal sac slightly.

It should be known that, at this level in the spine, there is no solid spinal cord present. The solid spinal cord usually ends around the level of T12 or L1. From that point on down to the end of the spine there are only nerve roots floating in the CSF. This is called the cauda equina (the tail of the horse). Thus, the disc may be pressing on the thecal sac, but there is no spinal cord for the disc to push on.

(A side note - This is why spinal taps (lumbar punctures) can be done in the lower back region without too much concern about causing any damage to the neural tissues. Since the nerve roots are just floating in the CSF, within the thecal sac, when the physician inserts the needle it does not hit any of the nerve roots. And, the physician can then take out some of the spinal fluid for analysis.)



4) Diffuse posterior disc bulge causing thecal sac indentation at L4-L5 and L5-S1 levels with bilateral neural foraminae narrawing at L4-L5 level

>> Again, at these two levels (L4-5 and L5-S1) there is a disc bulge that presses on the thecal sac.

At the L4-5 level there is also stenosis (narrowing) of the neural foraminae on both sides. The term foramen (plural foraminae) just means “hole”. So, the neural foraminae are the holes through which the nerve roots exit the spinal canal.

Again, it states that the foraminae are narrowed, but it does not state that the nerve roots are being pressed on or moved out of the way.




As to the significance of these findings, that is something that you need to discuss with your surgeon. All findings on any study have to be correlated with a patient’s history, symptoms, and physical examination.

These findings in one patient could be the cause of significant symptoms, but another patient may have the exact same findings, yet have minimal symptoms, if any. Again, this is why the finding have to be correlated with your situation.


Good luck. Wishing you the best.
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replied February 23rd, 2013
Thank you for your information
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