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I really need some advice about my mri

ricky41rricky41 Posts: 4
edited 06/11/2012 - 8:41 AM in Spinal Stenosis
I just had a dynamic fusion done the day before thanksgiving and the pain down my right leg into my foot has been getting worse. I just had an mri done a few days ago and I do not go see my doctor for another 8 days. Here are the results from my mri and if anyone can explain it or even any of it to me would be wonderfull. Thank you to anyone who can help me understand this.

I had an mri done and I got my results back. If anyone can help me with how the results came out are would be very helpfull. I just had my second back surgery in 2years and i'm only 27 i am very worried about the pain down my legs and loss of feeling in my legs and feet.

Findings: pedicle screws involve l4 and l5. Desiccation is present at l4-l5 and L1-L2. Disc space narrowing is present at L5-S1. The conus medullaris appears normal.

Minimal central bulging of the disc is present at L1L2.

The L2-L3 level demonstrates minimal bulging of the disc and spondylotic ridging with a small element of bilateral neural foraminal narrowing.

The L3-L4 disc space level demonstrates a laminectomy defect. Right-sided bulging of the disc is present and contributes to right greater than left neural foraminal narrowing. the central canal is well decompressed.

The L4-L5 disc space level demonstrates a laminectomy defect. A broad-based asymmetric disc protrusion-bulge is present which is more notable to the right of the midline. The finding results in right greater than left neural foraminal narrowing as well as some flattening of the ventral margin of the thecal sac. Enhancement of the soft tissues is seen along the right anterolateral margin of the thecal sac from presumed post-operative changes.

The L5-S1 level demonstrates miinor left-sided spondylotic ridging with minimal impingement upon the left neural foramen. Laminectomy defect is present. the central canal is well decompressed. Enhancement is seen along the right anterolateral margin of the thecal sac and right S1 proximal traversing nerve root from post-operative fibrosis.

1. Laminectomy defect invilve L3-L4 through L5-S1 with pedicle screws at both L4 and L5.
2. asymmetric disc protrusion- bulge at L4-L5 which is more notable to the right of midline resulting in right greater than left neural foraminal narrowing.
3. Bulging of the disc at the L3-L4 level which is minimally more pronounced to the right.



  • None of us on the board have proper training to interpret imaging results. Of course you will need to wait for an accurate report until you see your doctor. That being said, a couple things would jump out at me, if I were looking at this as my report....

    First, I'm not sure what you mean by a "dynamic" fusion. What was done that make it dynamic? It looks like they did a laminectomy from L3-S1 and that the fused part is at L4-5. Would that be correct?

    It's hard to say where your pain is coming from, although there are several bulges noted and also neural foraminal narrowing at several levels. Either of these can account for nerve compression. Also there appears to be some formation of fibrosis (scar tissue) along the edge of the thecal sac at L5-S1 and around the traversing S1 nerve root. This could be a cause for nerve pain...might be...maybe....If scar tissue is wrapping around or pressing up against the S1 nerve, this can cause leg pain.

    I'm not sure why you'd have a bulge at L4-5 since your fusion. I would have thought that would have been cleaned up during the surgery. You'll notice that most things mentioned are more pronounced on the right side -- again, where you report leg pain.

    Please let us know what you find out when you visit with your doctor. Be sure to ask him about the fibrosis at the L5-S1 level.

  • One thing to remember is that a radiologist reads xrays, he does not necessarily read them from a surgeon's standpoint. I like it when the surgeon looks at the films before he reads the report, gives me more faith in him.

    I think you are lucky to have an appt in 8 days. Do remember that if your pain level is too high or any other funkiness happens, call the surgeon's office. They leave spots open for emergencies and there may be a cancellation(especially if weather predicts snow.)

    Reading an MRI is difficult when you have hardware in. The hardware causes interference call artifact. Sometimes it can shadow over something that is there. MRI's are generally used to see soft tissues where as CT scans generally are used to see bone. A lot of times, surgeons will end up ordering both and comparing because that artifact shows up on CT, too.

    I hope you surgeon listens to you. You might think consider writing down a short story list to take with you(like date of surgery, date of this symptoms, etc.) It's often hard to remember that stuff when you're in pain and dr's(most) really find that easier to look at rather than listen to us sniffing and bawling(oh, maybe that's just me? :) ) They often want just the facts. In your short story, include if you had to increase meds, too.

    I know you asked for someone to read your MRI. I think that even if anyone here was qualified to do it, it should only be done with a thorough patient exam.

    Please post an update for us!
  • It's best to wait and see your Doctor about the results from your MRI. AS ER mentioned, you are reading the results from the Radiologist. The opinion that counts the most is your Surgeons.

    Gwennie, correct me if I'm wrong Ricky, a dynamic fusion is where they leave the disc in place and install hardware at the level desired. The rods are usually flexible to allow movement at that level in question. The theory is to stiffen the questionable level to stabilize it it.

  • Thanks for everyone opinion and yes the dynamic fusion is where they put 5 screws in my spine and flexible rods. No discs were taken out but the dr. did remove part of a disc that was bulging. That was done the day before thanksgiving but I had a laminectomy done 2 years ago. Yea I gonna call the doc's office now to see if they can fit me in becasue we are getting snow very soon and hopfully someone canceles.
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