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Latest lumbar MRI results

HuggyHHuggy Posts: 321
edited 06/11/2012 - 8:48 AM in Lower Back Pain
I posted a while ago about my cervical problems (severe central and foraminal stenosis with spinal cord compression, severe spondylosis and facet arthropathy, etc.). The neurosurgeon I saw recently suggested I have a more up-to-date MRI of my lumbar spine Here are the main results (with the repetitive bits omitted):

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46-year-old male with history of chronic low back pain.

MRI of L-spine without contrast in axial and sagittal sections:

There is extensive degeneration and spur formation throughout the lumbar spine and DJD was considered.

L2-3: Axial T2WI MR shows disc bulge compressing thecal sac.

L3-4: Axial T2WI MR shows disc protrusion compressing thecal sac with spinal stenosis.
Axial T2WI MR shows high signal zone in anulus at midline of L3-4 disc. Vertebral disc anular tear is suggested.

L4-5: Axial T2WI MR shows right-sided disc herniation with osteophyte formation compressing thecal sac with severe stenosis.
Axial T2WI MR shows marked facet hypertrophic degenerative arthropathy with enlarged facets, producing severe foraminal stenosis and spinal stenosis.

L5-S1: Axial T2WI MR shows left-sided disc protrusion with osteophyte formation compressing thecal sac.
Axial T2WI MR shows marked facet hypertrophic degenerative arthropathy with enlarged facets, producing severe foraminal stenosis and spinal stenosis.

Sagittal T1WI MR shows type II endplate changes due to fatty marrow replacement at L4-5 and L5-S1. There is grade 1 retrolisthesis of L4 on L5 and L5 on S1.

However, image findings may underestimate degree of spinal canal and nerve root compression. Please correlate with clinical manifestations and follow up.

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The findings are consistent with what the spine specialist in the US (whom I consulted last year) told me after looking at my previous MRI, although he did not mention the retrolisthesis. The MRI report doesn't mention the polyneuropathy that causes some of my pain, of course. I've seen several surgeons about my lower back over the last year or so and they all agree that it presents a difficult case as far as treatment goes. Most of them think I should continue with pain management for now. I asked the last neurosurgeon I saw what he would do if it was his back and he said he couldn't answer that and told me that maybe there would be new procedures available in the future. He also said that the last two levels of my L-spine are pretty much collapsed (there's almost nothing between the vertebrae, just thin, jagged black cracks), and he said a fusion operation may not do any good as far as pain is concerned.

I'm off to see more surgeons about the spinal cord and nerve root compression in my neck next, so I'm hoping to get some helpful suggestions about how to deal with that.
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13

Comments

  • Not sure exactly what your question is. Of course, since you've been a member for a while, you know we're not qualified here to read MRI's.

    As far as your lower back, it sounds like collectively you've been told to pursue pain management. Have you set up an appt. for this? Regarding the retrolisthesis, my NS told me not to worry about it as I had no instability from it.

    Not sure why you were told to get an updated lumbar MRI when you went to see an NS about your cervical problems. What are your symptoms? Any radiculopathy from this, etc.?

    Good luck with your future consults. Keep us posted.

    TC,

    Marianne
  • Hi Marianne, I didn't have any questions as such. I understand everything in my MRIs, so wasn't looking for interpretations, just a bit of empathy, I suppose - I usually just post in other folks' threads, and thought it was time I made one myself! I was just keeping anyone who might be interested posted, as I've noticed this is what a lot of folks here do (i.e. post updates on appointments, new findings, new treatments, dilemmas, etc.). I guess I wanted to share or 'offload' a little with others here in a similar boat, as all this has been on my mind a lot lately and it's hard to decide what to do next (esp. regarding the cervical stuff). Sharing with other people here seems to help sometimes, as I know members here understand what it's like. It's hard to talk about this stuff with people who haven't been through it.

    I should have clarified, the doctors I saw about my cervical issues didn't tell me to get another lumbar MRI. This was something other neurosurgeons suggested I do when I last went for a consultation about my lower back problems a couple of months ago. They wanted to see if there was any progression in the degeneration and retrolisthesis. The doctor seemed surprised when I brought him a year-and-a-half old MRI to look at.

    I should have mentioned, I've been in pain management for a long time (I've had chronic back pain for 20 years), and I'm not new to any of this, but it still gets to me sometimes.

    Thanks for your reply, and sorry for being so vague. It's late here, and I have insomnia, as usual...
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  • Hello Huggy...I am sorry that you are having to deal with all of this pain!!

    I am new to the cervical/upper back part of the spine...LOL...I have the lumbar covered...:)

    But I will keep you in my prayers and I will be looking for more of your updates!!!!
  • Thanks, Polly. I'm a newbie to the cervical stuff too. I only discovered recently that I had serious problems there when I started having weird arm symptoms - before that I just assumed I had a stiff neck from using the PC and reading too much. I've had lumbar problems since my mid-twenties, but the neck stuff kind of crept up on me!

    Thanks again for your concern, I appreciate it!
  • Hi, Huggy,
    From what I read I'm sure you're in a lot of pain ("severe stenosis", etc.) What can make it more frustrating is something I read in a recent newspaper article, that doctors can often have a hard time pinpointing the exact cause of it - especially when the sufferer has multiple back problems. Like everyone else on this Board, you'll be in my prayers, and I hope everything works out for you.
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  • Thanks, essmoe29 - I really appreciate it. The recent MRI reports and discussions with my doctors really brought it home to me what a bad state my spine is in. I was disheartened by how many times the word 'severe' was used - not the kind of word you want to hear when talking about your spine!

    I'm in a lot of pain right now, and it's increasingly difficult to do things without having to stop and collapse in a heap on the nearest seat, or whatever's available if I'm outdoors. It's like being squeezed in a vice and having coals inside my back getting gradually hotter and hotter until it becomes unbearable. Not to mention the constant grinding of bone against bone and the nerve compression causing all sorts of weird symptoms. It's really hard to put up with sometimes!

    Pain management here in Taiwan is not as sophisticated as it is in the US or Europe, so I don't have access to the kinds of things many PM patients take for granted. Much of the time I'm just grinning and bearing it, frankly. I'm usually able to get my pain level down from an average of 8 in the morning to about a 5 or 6 by early afternoon, but any sustained activity brings it back up again within minutes. It's got to the point where I'm considering going to stay with my aunt in the States for a while in the hope that I can get more effective pain control (and possibly some new ideas for solutions).

    Thanks again for your kind reply.
  • i think it helps to see others scan results, sorta helps you feel not so alone
    i have similiar issues to you , though my cervical has been something ive been aware of for 20 yrs as i have a lot of symptoms and have loss of ROM for years
    what sort of symptoms do you have from your lumbar, mine are extremely limiting and painfull
    my L4-L5 disc completly shattered/broke into bits, so i have vertebrea on vertabrea, no disc at all, now my NS says it should be fused, im wondering why yours recommends not.

    hope you get some answers with your consult for your cervical
    keep us updated
    take care flower
  • Thanks for updated us on your status. Yes, we like to hear members' updates, vents and status.

    When I read your lumbar MRI report, I understood your later statement about how difficult it is to stand or walk for a length of time and then feel the "hot coals" and have to sit or double over if that's the only option.

    I too had severe stenosis and hypertrophic facet joints at L4/5 and know how painful it can be to simply stand. At one point I had to have a stool in the kitchen simply to sit so I could cut vegetables for dinner. When my MIL asked hubby why this was necessary he replies "She just wants to try and live a normal life as much as she can right now!"

    When it's all inside the body and you can't see it, others don't really understand, but that's why this site is so valuable. Not only can you get info on your condition, but you know others will be able to related. I'm in the 'I can relate' catagory and feel for you, knowing the kind of pain this diagnosis can bring.

    Hang in there, Huggy, and good luck getting everything taken care of in the best way possible, be it surgery, pain management or anything else that helps.

    Cathie
  • post wasnt there when i replied, so i now can see your other information.
    i can very much relate to your symptoms/feelings, , my spine is in a similiar state to yours

    the not being able to walk thing is really hard,and not being able to bend over, along with all the other deterioation
    yes, i have the vice like grip deep inside my spine

    for me , for now, im looking at a fusion for one area, then look at the other areas for more fusions to help this mess

    ohh, my NS also said , fusion would not releive the back pain, another dr said, in the future there may be treatments...
    i really hope you can get something that works for you
    take care , keep us posted
    flower

  • Cathie and Flower, thanks so much for your kind thoughts! It really does help to know that others can relate to the kind of thing you're going through.
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