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Radiology Reports


I know we are not allowed to interpret Radiology Reports, but I just have a question. I recently had a CT scan of my Lumbar Spine. I am post A/P Lumbar fusion at L4/5 with cage. rods and screws. The Radiologist stated that I had multi- level Central Canal Stenosis and moderate Lateral Recess Stenosis. Most of the levels were called, " Moderate." Some were called, " Upwards From Moderate," What exactly is upwards from moderate? Is there a standard which Radiologists determine, mild, moderate, severe stenosis? Or is it just the Radiologist's call?

Also, on this report, It was stated that I had vacuum phenomena at the L4/5 disc space. I think this must be a typing error. I have the cage/spacer and had the A/P fusion with all the hardware done at this level. The fusion was done in 2012, although, I never obtained pain relief from the surgery.

Just asking if anyone has any knowledge of how they make their determination. Thanks.
Take care and God Bless,
Mary Anne


  • dilaurodilauro ConnecticutPosts: 9,877
    heard of either
    Upwards from Moderate
    Vacuum Phenomena

    The upwards is puzzling. Like you said Upward from Moderate equals what = Severe???

    That is something you got to get an answer from your doctor on
    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
  • I also have the vaccuum phenomena in my reports as well. And I am still not sure what it means. Upwards of moderate simply means that the condition does not mean the criteria of severe yet, but it is more than a moderate amount.....
  • Thanks so much for your answers. I was still wondering, how do different radiologists interpret moderate, mild, severe, etc? Do they use a standard measurement or is it different accordingly to the doctor reading the films.
    I guess they compare the current films to your previous MRI or CT scan to see if your stenosis is progressing, also. It did mention that it was. I am only 2 years out of a 360 fusion, with BMP on L4/5 and this is all bone spurs on the adjacent segments.
    Take care and God Bless,
    Mary Anne
  • There is a scale, if you search on the radiology websites, you can read about references to various scales used in determining spine issues.
    I think that the school that the radiologists go to also influences which scales they use. http://www.asnr.org/spine_nomenclature/introduction.shtml
  • Hi Sandi,

    Thanks so much. Everything I've read said it is subjective from doctor to doctor, also.
    Take care and God Bless,
    Mary Anne
  • sandisandi Posts: 6,342
    edited 09/19/2014 - 6:24 AM
    There are average measurements of the average diameters of foramina and canals taken amongst various populations, that are used as the basis for the scales , so ranges of diameters are used , for determining where the measurements fit into those averages.
    Each level of the spine has a reference range.....
  • is an air bubble inside the vertebra for lack of a better way of describing it.
  • So, Vacuum Phenomenoa really has nothing to do with the disc space or stenosis. Although. my CT Scan said my disc height was decreased at this level. It is just a common finding on the vertebrae, like Schmorl's nodes. I have plenty of them.
    I couldn't understand because I was fused at that site.

    However, my walking, leg weakness is deteriorating, R foot drop is progressing to the point that my doctor advised me to get a walker last week. I just had an caudal last week and am going to try physical therapy next month.

    For the last 2 years, I thought I had a cage. I found out they used Infuse last Spring. Now, I just found out the surgeons who did my 360 fusion never used a cage. Has anyone else received Infuse without a cage?

    I am wondering if the cancer risk is higher .

    Take care,
    Mary Anne

    Take care and God Bless,
    Mary Anne
  • I have it in both the vertebra and in the disc space where the fusion failed to complete......so I have to assume that it can effect disc space height. I meant to ask when it was seen on the last report, but with all of the other stuff going on in mine, I completely forgot to.
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