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Looking for interpretation of MRI results a-LAYMAN's Explaination

AnonymousUserAAnonymousUser Posts: 49,900
I have recently completed an MRI and the findings puzzle me. What I NEED is a lay-persons's explaination AND a sober sound second opinion regarding treatment options.



On the localized scan mild disc bulges are noted in the cervical spine at the C5-C6 and C6-C7 levels.

Alignment of the lower thoracolumbar spine is maintained. A small Schmorl's node is present at the superior endplate of L3. Otherwise height and signal of the vertebral bodies is unremarkable.

There is minimal disk desiccation at L3-L4; L4-L5 and L5-S1 levels without loss of height.

Conus Modularise terminates posterior to the L1.

The L2-L3 level shows no disk bulge or protrusion,

The L3-L4 levels shows minimal bulging of the annulus in the left foraminal and far lateral locations. Mid-mild to moderate facet joint arthropathy and ligamentum flavum thickening are present. Mild neural foramina narrowing is present bilaterally without evidence of nerve root impingement.

The L4-L5 level shows a broad-based disk bulge extending from one paracentral location to the other. Moderate bilateral facet joint arthropathy and ligamentum flavum thickening is noted. Mild to moderate narrowing of the bilateral neural foramina. There is mild contact with the exiting bilateral L4 nerve roots. Please correlate for L4 radiculopathy. There is also mild lateral recess narrowing. Central canal remains patent.

The L5-S1 level shows mild to broad-based bulging of the annulus resulting in slight contact with the anterior thecal sac. Mild bilateral facet joint arthropathy is seen. Posterior vertebral marginal osteophyte is noted on the left side. There is mild to moderate narrowing of the left foramina and mild narrowing of the left foramina and mild narrowing of the right neutral foramina. There is contact with and possible mild compression of the exiting left L5 root as it courses through the neutral foramina.

What the heck does this diagnosis all mean.

The first thing out of my doctor’s mouth was that we should make an appointment with a neurosurgeon. Not that this is out of the question but I would prefer it to be an option and not the only consideration as a course of action.

Since this accident that caused this problem (fall on the ice December 2007) I have been through plenty of treatments ranging from Chiropractors (2 months) to Physiotherapy (4 months) along with massage therapy and have made substantial positive gains in my personal health related to pain management. The major symptoms I have these days are lower back pain (intermittent) numbness on the inside of my left foot (cold feeling and weakness at times as well) intermittent weakness in my left leg and stiffness if I don’t move about with regularity. Generally speaking the strong unbearable pains I had experienced (sciatica) have subsided to the point where there are many many more times when I don’t have pain verses having pain.

So, is surgery the only option I should consider! Unfortunately my doctor does not like to be questioned regarding their suggestions. As such I am treading carefully so as not to upset Doc and risk being removed from his patient list as a patient who will not follow their physician’s advise. (Canadian medical care system has too few family physicians).

So... I’m looking for some advice, some sound advise from those who have been where I am today.

Any thoughts or comments are welcome and taken in the spirit they are given
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Comments

  • I can understand the about the Canadian health care system (and the fall on the ice That's how I hurt my back to). I'm in Canada too, and I am having problems with my family Dr. However there are no Dr's taking new patients where I live.

    Aboyt the surgery question, I have no idea. I am still new to back problems. In other threads I've read a lot of people saying that you should try all conservitave treatment before surgery. Have you tried injections yet? It was the only thing that stuck me as missing on your lists, and I've read that they have helped some people.

    Sorry I can't be more help.
  • Welcome to Spine Health.

    A visit to the neurosurgeon doesn't always translate to surgery. Basically when a primary care physician isn't quite clear on the results of an MRI, he/she will refer you to a spine specialist for evaluation.

    Remember, it's your body, and if you don't want surgery you don't have to have surgery.

    With the Canadian Health System I have no idea what the ramifications might be if you refuse a docs prescribed treatment.

    "C"
  • I will most likely get into trouble for doing this, but I will try and be a thesaurus for you on this.

    Now the official disclaimer: I am not a doctor, I have no medical training. The following is an opinion only and is a best attempt to describe a technical document. I am a private person and have no affiliation to Spine ealth or any of its affiliate.

    I hope that spares me anguish from my Admin friends.....

    Here we go:

    STATEMENT: On the localized scan mild disc bulges are noted in the cervical spine at the C5-C6 and C6-C7 levels.

    TRANSLATION: Yhe invertabral disks, which are multiple layer of soft tissue, aare slightly bulging outside of normal limits at the lower 2 vertebral sections of the neck.


    STATEMENT: Alignment of the lower thoracolumbar spine is maintained. A small Schmorl's node is present at the superior endplate of L3. Otherwise height and signal of the vertebral bodies is unremarkable.

    TRANSLATION: The spine is straight and no curvature is present. A small upward and/or downward protrusion of the spinal disk's soft tissue at L3 is present. Otherwise the spine appears normal.


    STATEMENT: There is minimal disk desiccation at L3-L4; L4-L5 and L5-S1 levels without loss of height.

    TRANSLATION: You have very mild shrinkage of the disks at the lumbar vertabraes at three levels.

    STATEMENT: Conus Modularise terminates posterior to the L1.

    TRANSLATION: The conus medullaris is the terminal end of the spinal cord. It occurs near lumbar nerves 1 (L1) and 2 (L2). In your case he states that is terminates in a normal pposition.


    STATEMENT: The L2-L3 level shows no disk bulge or protrusion,

    TRANSLATION: They are not herniated


    STATEMENT: The L3-L4 levels shows minimal bulging of the annulus in the left foraminal and far lateral locations. Mid-mild to moderate facet joint arthropathy and ligamentum flavum thickening are present. Mild neural foramina narrowing is present bilaterally without evidence of nerve root impingement.

    TRANSLATION: There is mild herniation of the disk at L3/4 in the largest portion of the disk, the annulus and they are pushing toward the left of the spinal cord. The disk is not pressuring the nerve root or spine at this time.


    STATEMENT: The L4-L5 level shows a broad-based disk bulge extending from one paracentral location to the other. Moderate bilateral facet joint arthropathy and ligamentum flavum thickening is noted. Mild to moderate narrowing of the bilateral neural foramina. There is mild contact with the exiting bilateral L4 nerve roots. Please correlate for L4 radiculopathy. There is also mild lateral recess narrowing. Central canal remains patent.

    TRANSLATION: There is a herniation at the :4/ level pushing toward both sides of the spinal cord. You have mild artherhitis in th facet joints of L4/5 (maybe both). The ligaments holding the L4/5 joints in-place is thickening. You have a narooeing of the space where the nerve root leaves the verebral column at L4 and it is contacting the nerv root physically. They are asking your doctor to correlate the finding of nerve contact with radiating pain in the hips and legs. The central spinal canal is fine.


    STATEMENT: The L5-S1 level shows mild to broad-based bulging of the annulus resulting in slight contact with the anterior thecal sac. Mild bilateral facet joint arthropathy is seen. Posterior vertebral marginal osteophyte is noted on the left side. There is mild to moderate narrowing of the left foramina and mild narrowing of the left foramina and mild narrowing of the right neutral foramina. There is contact with and possible mild compression of the exiting left L5 root as it courses through the neutral foramina.

    TRANSLATION: Mild herniation od the disk at L5/S1. This one is contacting the spinal cord. You have mild artherhitis in the facet joints at this level. You have an artherhitic bone spur/deposit on the left side of L5 where the nerve roo exits the spinal column and the hole that the root exits is narrowed. The right root exit is narrowed as well. There is direct nerve root to bone contact at the L5 level and the nerve appears compressed at this level. The contact is throughout the root exit hole.


    Whew, that was fun.


    What does it all mean? well, the short answer is that there is a problem and you already know it. The long answer is to do what you need to to get better. That can be nothing, conservative treatments like hydro-therapy, injections, meds, etc. Or you can go surgical.

    This is where it gets really hard because all of us faced it and made our decisions based upon our own beliefs, needs, and understanding of the conditions that led us here.

    Talk to your doc, get a second opinion, and dont rush. You need time to understand it all and assess where you are in life and what your expectations are for the future.


    Best of Wishes,
  • I'll add my disclaimer too....I do not diagnose and love srtayl's translations as well as "C"'s post the surgery decisions are yours.

    The thing about going to a neurosurgeon is totally appropriate you need to know their recommendations and get a second opinion. It's not just a pain issue and it sounds like you're apprehensive because the pain is better. However when you have neurological symptoms (numbness,tingling,weakness etc.) it should be advised by a neuro doc as to what the recommendations are...can it get better without surgery? can is worsen? can it be permanent without surgery?

    It doesn't sound like a major surgery like fusion or anything in fact if that is what your first consult says then for sure get a second opinion and then another. Sometimes when the nerves are being violated so to speak a simple decompression might halt the neurological problems you're having. The reading also refers to asking your doc about pain correlation like the "translation" says because sometimes that may show up on someone else's MRI and the patient may not have symptoms so when you do that would also be considered neurological in nature kind of like a reason for the pain, the nerve is not happy.

    So good luck!!! It sounds like you're on track to find out where ya stand. Again though just because you're going to a surgeon does NOT always mean surgery....

  • The explanation srtayl provided was excellent from what I understand. (nice job srtayl!) If you want an even simpler explanation...it seems you have some herniated discs, some mild arthritis, some stenosis, some nerve irritation, and a bone spur. It sounds like a lot of "bad stuff", however it's not as bad as you might think.

    Do you need surgery? Probably not right now because, as you said, you're feeling better-generally surgery is advised when one's quality of life is so affected, and all conservative methods of treatment (injections, meds, PT, etc) have been exhausted, and you're so miserable from the pain that you and your Doctors feel there's no other alternative. But you should be seen by a surgeon who will evaluate you, look at your MRI, and tell you what he/she thinks you should try next. Like the others have said, seeing a surgeon does not necessarily mean needing surgery. The sensations you're feeling in your foot are likely due to the nerve impingement. This could be alleviated with a nerve pain medication such as Lyrica or Neurontin, or with a disc decompression surgery, where they remove the herniated portion of the disc. I'm not real familiar with bone spurs (osteophytes) as far as whether or not you have to have them removed or if that can wait until you have an increase in symptoms, but I do know that they can cause pain and other problems and it is a sign of problems.

    Here is a website that is designed to help people understand and read their MRI reports and films..I think it will be very helpful for you: www.chirogeek.com It is worded so that the average Joe can understand, as can those of us with medical knowledge/experience. I have found it very helpful and refer to it every time I have a new MRI or CT scan. Hopefully it will help you as well.

    I wouldn't worry too much right now. You seem to be feeling ok all things considered, and that's the most important thing. Lots of people have specific things going on in their spine and have no symptoms from it, and others have 1 mild "little" thing and are in tons of pain. Once you see the Neurosurgeon and have your questions answered (write them down so you won't forget to ask!) I'm sure you'll feel much better about everything. In the meantime, if you do have pain, there are lots of things that can be tried as already mentioned (meds, injection, PT, aqua therapy, TENS, massage, accupuncture...and so much more!).

    Maybe if you peruse around the boards and read the posts under various threads you'll feel a bit better and learn more, plus be sure to look at the articles and information also available here at SH! Arming yourself with a wealth of knowledge will be the best thing for you, both mentally as well as physically.

    Take care, and I hope you'll keep us posted as to what's going on, what the NS says, etc. :)
  • Point of clarification:

    < Same disclaimer as you :) >

    The spinal cord ends between L1 and L2. Below that is the cauda equina which is inside of the thecal sac. So technically the herniation is not contacting the spinal cord.


    We now return to the regularly scheduled progam. 8}
  • dilaurodilauro ConnecticutPosts: 9,715
    Interpreting any MRI results. Many members can comment on what your readings are and give some meaning behind them.
    BUT please be aware that the posts you are receiving here is NOT formal medical advice. Some members probably have a good idea on how to interpret the readings, but still, just realize that this is only members advice based on their experiences.
    Always get the formal readings from your Doctor(s)
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • He found me!

    Like I said, Best Wishes,
  • I just had an MRI done this week. The results are as follows:

    1. Post sergical change at L4-5

    2. There is small amount of Enhancing Scar Tissue within the right neural foramen at L4-5 Producing mild narrowing of the right neural foramen.

    3. Bilateral Facet Arthropathy at L5-S1.


    Can someone help understand Please. And should i go back to my neurosergeon? Thanks.
  • severe bilateral facet arthrosis at every lumbar level however most significant at L4 through L5 where there is resultant severe narrowing of both neural foramen and compression of both exiting L4 nerve roots.very mild degenerative disc changes throughout the lumbar spine with mild central canal narrowing at l3 l4 l5.
    Angela Gomez
  • LizLiz Posts: 7,900
    edited 08/12/2014 - 9:23 PM

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Thank you everyone, I know we are just having conversation about our illnesses and I will not hold anyone accountable for anything, I just wanted a straight answer which is what I got, thank you so much. And I hope you ask didn't get in trouble. :)
    Angela Gomez
  • sm7510ssm7510 Posts: 2
    edited 10/15/2014 - 9:06 PM
    I recently got my MRI done. Doctors say it's normal. Orthopaedic doctor suggested to have pain killers and I have been having it since a month now.

    Got my MRI results.. could someone please explain what it means

    Findings: Mild disc degenerative changes and facet osteoarthritis at L5-S1 associated with vertebral osteophyte formation.
    Small left paracentral disc bulge at L5-S1 is noted.

    Please help me understand my reports.
    As I still have pain.
    THANKS

    There is nobody on the forum qualified or permitted to interpret an mri finding..
    http://www.spine-health.com/forum/announcements/spine-health-announcements/mri-reports-why-we-cant-advise
  • sandisandi Posts: 6,448
    edited 10/16/2014 - 3:29 AM
    That information needs to come from your doctor. When are you supposed to see the doctor again? He will go over the reports with you, and let you know what can be done as far as treatment goes.
  • 123sha1123sha ventura ctyPosts: 1
    dear srtayl , 
    I really liked your interpretation of above MRI and how you put it in Laymans terms for a reader . By any chance can you give your interpretation on one more? please let me know, I will forward if you are willing to take a look at an give your 
    nterpretation. l am having hard time reading the information as well interpreting the medical terms. if you do decide to take a poke at it, i would very much appreciate your interpretation. Thank you
  • apaliwaaapaliwa GurgaonPosts: 1

    Hi,

    I need some suggestion for My Father MRI report. My Neurologist has suggested to consult with a surgeon. Please check the below MRI report result (cervical Spine) and let me your suggestion.

    Disc desiccation with posterior osteophytes disc complex and facet joint hypertrophy is seen at C3-4 level causing compression on thecal sac and cord with narrowing of bilateral neural foramina (L>R).

    Disc desiccation with posterior ostrophytes disc complex and facet joint hypertrophy is seen at C4-5 level causing severe compression on thecal sac and cord with narrowing of bilateral neural foramina (R>L). Hyperintense signal changes seen in the spinal cord at this level s/o compression myelopathy.

    disc desiccation with diffuse concentric disc bulge and facet joint hypertrophy is seen at C5-6 & C6-7 level causing indentation over thecal sac and narrowing of bilateral neural foramina

    cerebellar tonsils are normal location.

    cervicomedullary and craniovertebral junctions do not reveal any significant abnormality.


    My father is 66 years old.

    Many many thanks in advance for any suggestions.

    Thanks

    Abhishek Paliwal

    Jaipur , India

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